Clinical study of levosimendan combined with enalapril in treating acute anterior wall myocardial infarction complicated with cardiac dysfunction after emergency PCI

doi:10.11958/20241218

Abstract

Abstract:

Objective To investigate the efficacy of levosimendan combined with enalapril on acute anterior wall myocardial infarction complicated with cardiac dysfunction after emergency percutaneous coronary intervention (PCI).Methods Ninety-eight patients with acute anterior wall myocardial infarction who underwent emergency PCI surgery and developed heart failure were prospectively selected, and randomly divided into the single group and the combined group, 49 patients in each group. The single group received enalapril at a dose of 5 mg/(times · day). The combined group received levosimendan on the basis of the single group, with an initial dose of 6 μg/kg within 10 minutes after the start of intravenous injection, and the adjusted dose was 0.1 μg/(kg·min) after 10 minutes. The infusion lasted for 24 hours. The effects, improvement in Killip heart function classification, cardiac remodeling indicators [left atrial diameter (LAD), left ventricular ejection fraction (LVEF), interventricular septal thickness (IVST) and left ventricular end-diastolic diameter (LVEDD)], serological indicators [creatine kinase isoenzyme (CK-MB), cystatin C (Cys C) and cardiac troponin I (cTnI)], 6-minute walk distance and incidence of adverse reactions were compared between the two groups.Results The overall effective rate was higher in the combined group than that of the single group (P<0.05). After treatment, the cardiac function was better in the combined group than that of the single group.Data of LAD, IVST, LVEDD, CK-MB, Cys C and cTnI were lower in the combined group than those of the single group, and LVEF was higher in the combined group than those of the single group (P<0.05). The distance of the 6MWT was longer in the combined group than that in the single group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups.Conclusion Levosimendan in combination with enalapril is effective in treating patients with acute anterior wall myocardial infarction complicated with cardiac insufficiency after emergency PCI, which can effectively reduce myocardial injury, improve cardiac and renal functions, and has high safety.

Key words: anterior wall myocardial infarction, Enalapril, Simendan, percutaneous coronary intervention, ventricular remodeling, cardiac function

CLC Number:

R605.975，R542.22

Figures/Tables 6

References 22

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组别		男性		体质量指数/（kg/m²）		年龄/岁		高血压		高血脂
单一组		25（51.02）		23.16±2.23		63.29±6.38		21（42.86）		24（49.98）
联合组		29（59.18）		23.25±2.26		63.14±6.35		19（38.78）		26（53.06）
χ²或t		0.660		0.177		0.111		0.169		0.163
组别	糖尿病		吸烟史		急性前壁心肌梗死家族史		血管紧张素转换酶抑制剂		血管紧张素受体拮抗剂
单一组	13（26.53）		32（65.31）		11（22.45）		13（26.53）		8（16.33）
联合组	9（18.37）		28（57.14）		13（26.53）		9（18.37）		10（20.41）
χ²	0.938		0.688		0.221		0.938		0.272

组别		男性		体质量指数/（kg/m²）		年龄/岁		高血压		高血脂
单一组		25（51.02）		23.16±2.23		63.29±6.38		21（42.86）		24（49.98）
联合组		29（59.18）		23.25±2.26		63.14±6.35		19（38.78）		26（53.06）
χ²或t		0.660		0.177		0.111		0.169		0.163
组别	糖尿病		吸烟史		急性前壁心肌梗死家族史		血管紧张素转换酶抑制剂		血管紧张素受体拮抗剂
单一组	13（26.53）		32（65.31）		11（22.45）		13（26.53）		8（16.33）
联合组	9（18.37）		28（57.14）		13（26.53）		9（18.37）		10（20.41）
χ²	0.938		0.688		0.221		0.938		0.272

组别	n	显效	有效	无效	总有效
单一组	49	21（42.86）	15（30.61）	13（26.53）	36（73.47）
联合组	49	27（55.10）	18（36.73）	4（8.16）	45（91.84）
χ²		4.555^＊

组别	n	显效	有效	无效	总有效
单一组	49	21（42.86）	15（30.61）	13（26.53）	36（73.47）
联合组	49	27（55.10）	18（36.73）	4（8.16）	45（91.84）
χ²		4.555^＊

组别	治疗前心功能（Ⅰ级/Ⅱ级/Ⅲ级）	治疗后心功能（Ⅰ级/Ⅱ级/Ⅲ级）	Z
单一组	0/17/32	18/19/12	5.175^＊＊
联合组	0/23/26	21/27/1	6.288^＊＊
Z	0.904	2.018^＊