J Vis Exp. 2026 Oct 16;(236). doi: 10.3791/72402.
ABSTRACT
Elderly patients with concurrent coronary artery disease (CAD) and hypertension face elevated risks of cardiovascular events and require therapies that balance efficacy, safety, and tolerability. Sacubitril/valsartan has demonstrated benefits in heart failure management, but evidence regarding its long-term cardiovascular outcomes in this specific population remains limited. This retrospective cohort study enrolled 150 elderly patients with CAD and hypertension to compare the effects of sacubitril/valsartan versus amlodipine, both combined with conventional therapy. The primary endpoint was the incidence of major adverse cardiovascular events (MACE) over 12 months. Two MACE definitions were applied in this study. Primary analysis used our predefined composite endpoint, including aggravated heart failure and arrhythmia events. A sensitivity analysis adopted the conventional MACE definition (myocardial infarction, stroke, cardiovascular death, revascularization), excluding isolated ventricular premature beats. Secondary endpoints included blood pressure control, cardiac function parameters, and treatment-related adverse events. Results showed that patients treated with sacubitril/valsartan had a significantly lower incidence of MACE (10.26% vs. 27.14%, P = 0.008), superior blood pressure control, and improved left ventricular ejection fraction (LVEF) compared to the amlodipine group. Cox proportional hazards regression (Cox regression) analysis identified sacubitril/valsartan treatment as an independent protective factor against cardiovascular adverse events (hazard ratio (HR) = 0.38, 95% confidence interval (CI): 0.18-0.80, P = 0.011). Both regimens were well-tolerated, with no severe adverse events reported. These findings indicate that sacubitril/valsartan is an effective and safe therapeutic option for elderly patients with CAD and hypertension, reducing long-term cardiovascular risk while improving blood pressure control and cardiac function.
PMID:42891596 | DOI:10.3791/72402