AUTHOR=Li Zhengwei , Fu Guosheng 

TITLE=Assessment of Ultra-Early Administration of Sacubitril Valsartan to Improve Cardiac Remodeling in Patients With Acute Myocardial Infarction Following Primary PCI: Rational and Design of a Prospective, Multicenter, Randomized Controlled Trial

JOURNAL=Frontiers in Physiology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2022.831212

DOI=10.3389/fphys.2022.831212

ISSN=1664-042X

ABSTRACT=Background: Despite coronary re-vascularization, the common complications of acute myocardial infarction (AMI), cardiac remodeling and heart failure, is increasing globaly. Sacubitril valsartan (SV), an angiotensin receptor-neprilysin inhibitor, has been previously demonstrated to improve heart failure. We further hypothesize that ultra-early SV treatment is also effective in preventing cardiac remodeling for patients with AMI following primary PCI.
Methods: The ASV-AM trial is a prospective, multicenter, randomized controlled trial in China planning to enroll at least 1942 eligible patients from 10 centers. After successful primary PCI of culprit artery within 24 hours, AMI patients are randomized to 2 hours group or 3-7 days group with SV treatment. The major endpoints are echocardiographic measurement, cardiothoracic ratio and NT pro-BNP at baseline, 1, 3, 6 and 12 months. The secondary endponts included MACE (cardiac arrest, cardiogenic death, myocardial infarction and target vessel re-vascularization), in-/out-patient heart failure (HF), EuroQol Five Dimensions Questionnaire (EQ-5D) and Kansas City Cardiomyopathy Questionnaire (KCCQ). 
Discussion: The ASV-AMI trial is the first clinical trial of ultra-early administration of SV in the treatment of post-PCI AMI, adding more clinical evidence. Early application of SV to prevent cardiac remodeling in AMI patient is a major focus of this trial.