Abstract | OBJECTIVE: RESEARCH DESIGN AND METHODS: Among the overall population of 1,512 patients, 303 (20.0%) had diabetes. The primary end point of this study was the effect of treatment on the 6-week combined occurrence of death and severe congestive heart failure (CHF). Secondary end points included the evaluation of the 6-week rate of major cardiovascular events as well as the 1-year survival rate. RESULTS: After 6 weeks of double-blind treatment, zofenopril significantly reduced both the incidence of the primary end point (8.6 vs. 18.3%; P = 0.019) and the 6-week incidence of severe CHF (0 vs. 7.3%; P = 0.001) in diabetic patients, and the effect was greater than that observed in nondiabetic patients. Conversely, 1-year mortality was significantly reduced among nondiabetic patients (9.1 vs. 13.8%; P = 0.010), whereas in the diabetic population, the decrease did not reach statistical significance (13.7 vs. 16.5%; P = 0.52). CONCLUSIONS: The present data suggest that the clinical outcome of patients with diabetes and myocardial infarction can be significantly improved by early treatment with zofenopril. The lesser effect on 1-year mortality seems to suggest that long-term treatment is probably needed to maintain the benefits of the early ACE inhibition in patients with diabetes.
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Authors | Claudio Borghi, Stefano Bacchelli, Daniela Degli Esposti, Ettore Ambrosioni, SMILE Study |
Journal | Diabetes care
(Diabetes Care)
Vol. 26
Issue 6
Pg. 1862-8
(Jun 2003)
ISSN: 0149-5992 [Print] United States |
PMID | 12766124
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Angiotensin-Converting Enzyme Inhibitors
- zofenopril
- Captopril
- Creatine Kinase
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Topics |
- Aged
- Angiotensin-Converting Enzyme Inhibitors
(therapeutic use)
- Captopril
(analogs & derivatives, therapeutic use)
- Creatine Kinase
(blood)
- Diabetes Complications
- Diabetes Mellitus
(epidemiology)
- Double-Blind Method
- Female
- Heart Failure
(epidemiology)
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(drug therapy)
- Risk Factors
- Smoking
- Survival Analysis
- Time Factors
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