Improving cardiac function of angiotensin receptor/ neprilysin inhibitor in patients with acute myocardial infarction: a systematic review and meta-analysis

Qiuli Niu, Changyuan Wang, Xiurong Xing

Abstract

Aim: As the impact of angiotensin receptor/neprilysin inhibitor (ARNI) on cardiac function in acute myocardial infarction (AMI) patients is unclear in clinical therapy, we conducted this research to investigate the actual effects of improving cardiac function with ARNI in AMI patients.
Methods: Publications were checked up to June 2022. Standardised mean differences (SMD) and 95% confidence intervals (CI) were utilised for assessing the size of the effect of continuous variables. To assess the magnitude of the effect of dichotomous variables, a relative risk (RR) with 95% CI was used.
Results: ARNI could improve left ventricular ejection fraction (SMD = 0.40; 95% CI: 0.23–0.58), while lowering left ventricular end-diastolic volume (SMD = –0.43, 95% CI: –0.78 to –0.08), left ventricular end-systolic volume (SMD = –0.39, 95% CI: –0.66 to –0.11) and left ventricular enddiastolic diameter (SMD = –0.49; 95% CI: –0.65 to –0.33). Besides, it could decrease the rates of major adverse cardiac events (RR = 0.55; 95% CI: 0.43–0.69) and heart failure (RR = 0.42; 95% CI: 0.31–0.58).
Conclusion: ARNI could greatly improve cardiac function in AMI patients.