Abstract: Objective To investigate the clinical efficacy and safety of sacubitril valsartan （ARNI） in the treatment of patients with acute myocardial infarction（AMI） complicated with hypertension after percutaneous coronary intervention（PCI）. Methods A total of 124 patients with AMI complicated with hypertension after PCI in 24 hours from October 2020 to April 2022 in the Affiliated Hospital of Jianghan University were selected and divided into the study group and the control groups according to the random principle. 64 cases were treated with maximum tolerable dose of ARNI as the study group，while 60 cases were treated with valsartan as the control group，with a follow-up for 26 weeks. The changes in left ventricular end-diastolic diameter （LVEDD） ， left ventricular ejection fraction （LVEF），N- terminal pro-B- type natriuretic peptide（NT-proBNP），mean systolic blood pressure（SBP），mean diastolic blood pressure（DBP）and mean heart rate（HR） before and after the treatment were compared between the two groups. The rates of adverse cardiovascular events and drug adverse reactions were observed during follow-up. Results ① LVEDD，NT-ProBNP，the mean SBP，and the mean DBP significantly decreased， and LVEF significantly increased in both groups after the treatment （P < 0. 05 for all comparisons）. ② LVEDD，NT-ProBNP，and the mean SBP were significantly lower， and LVEF was evidently higher in the study group than in the control group after the treatment（P < 0. 05 for all comparisons）. ③ There was no difference in the incidence of adverse reactions and major cardiovascular adverse events between the two groups（P > 0. 05 for all comparisons）. Conclusion ARNI is superior and safe to valsartan in improving left ventricular remodeling，protecting cardiac function，and reducing SBP in patients with AMI complicated with hypertension after PCI.

Key words: sacubitril/valsartan, acute myocardial infarction, hypertension, ventricular remodeling, cardiac function