The Effects of Sacubitril-Valsartan vs Enalapril on Left Ventricular Remodeling in ST-elevation Myocardial Infarction

A Multi-center, Prospective Randomized Controlled Trial on the Effects of Sacubitril-Valsartan vs Enalapril on Left Ventricular Remodeling in ST-elevation Myocardial Infarction

The primary objective of the PERI-STEMI trial is to assess whether sacubitril-valsartan is more effective in preventing adverse LV remodeling for patients with ST-elevation myocardial infarction (STEMI) than enalapril.

Inclusion Criteria:

• Aged between 18 - 75 years old
• First-time ST-segment elevation myocardial infarction based on the newest ESC guidelines
• Timely primary percutaneous coronary intervention within 12 hours from onset
• Written informed consent acquired

Exclusion Criteria:

• Known history of or persistent clinical chronic heart failure prior to randomization
• Previous use of ARNI, or intolerance or contraindications to study drugs including ARNI or ACEI
• History of significant chronic coronary obstruction and adverse ventricular remodeling
• History of any cardiomyopathy, valvular heart disease, congenital heart disease, stent or CABG, or planned open-heart surgery within 3 months
• History of hepatic impairment or history of cirrhosis with evidence of portal hypertension
• History of chronic renal dysfunction, or eGFR < 30 ml/min/1.73 m2
• History of malignancy and with a life span less than one year
• Patients with a known history of angioedema related to previous ACEIs/ARB therapy.
• With contraindication to MRI examination (pacemaker and claustrophobia) or cannot finish breath-holding when lying on the examination bed
• Pregnancy or nursing women