Effects of early treatment with zofenopril in patients with myocardial infarction and metabolic syndrome: the SMILE Study.

Abstract

OBJECTIVE:

To evaluate the clinical efficacy of the early administration of zofenopril in a group of patients with and without metabolic syndrome (MS+ and MS-) and anterior myocardial infarction enrolled in the Survival of Myocardial Infarction Long-Term Evaluation (SMILE) Study.

METHODS:

Patients were randomized double-blind to zofenopril (n=719) or placebo (n=699) for 6 weeks. The primary end point was the effect of treatment on the 6-week combined occurrence of death and severe congestive heart failure. The secondary end point was the 1-year mortality rate.

RESULTS:

Of the 1418 patients included in this post-hoc analysis, 686 (48.3%) had MS. After 6 weeks of treatment zofenopril significantly reduced the incidence of all-cause death and severe congestive failure (risk reduction: 69%, 95% CI: 7-78; 2p=0.002) in MS+ patients. This was the case for 1-year mortality, too (29%, 95% CI: 4-41; 2p=0.048). Zofenopril was effective also in MS- patients but the amount of relative risk reduction was less than in MS+ for both the primary (-11%; 2p=0.61) and secondary endpoint (-19%; 2p=0.025).

CONCLUSIONS:

Results of this post-hoc analysis of the SMILE Study demonstrate the striking benefit of early administration of zofenopril in MS+ patients with acute anterior myocardial infarction.

• Authors: Claudio Borghi, Arrigo F G Cicero, Ettore Ambrosioni
• Journal: Vascular health and risk management (Vasc Health Risk Manag) Vol. 4 Issue 3 Pg. 665-71 ( 2008) ISSN: 1176-6344 [Print] New Zealand
• PMID: 18827916 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• zofenopril
• Captopril

Topics

• Aged
• Angiotensin-Converting Enzyme Inhibitors (administration & dosage, therapeutic use)
• Blood Pressure (drug effects)
• Captopril (administration & dosage, analogs & derivatives, therapeutic use)
• Comorbidity
• Female
• Heart Failure (epidemiology)
• Humans
• Incidence
• Male
• Metabolic Syndrome (drug therapy, epidemiology)
• Middle Aged
• Myocardial Infarction (drug therapy, epidemiology)