The SMILE-4 study showed that in patients with left ventricular dysfunction (LVD) after acute myocardial infarction, early treatment with zofenopril plus acetyl salicylic acid is associated with an improved 1-year survival, free from death or hospitalization for cardiovascular (CV) causes, as compared to ramipril plus acetyl salicylic acid. We now report CV outcomes during a 5-year follow-up of the patients of the SMILE-4 study. Three hundred eighty-six of the 518 patients completing the study (51.2%) could be tracked after the study end and 265 could be included in the analysis. During the 5.5 (±2.1) years of follow-up, the primary endpoint occurred in 27.8% of patients originally randomized and treated with zofenopril and in 43.8% of patients treated with ramipril [odds ratio (OR) and 95% confidence interval, 0.65 (0.43-0.98), P = 0.041]. Such a result was achieved through a significantly larger reduction in CV hospitalization under zofenopril [OR: 0.61 (0.37-0.99), P = 0.047], whereas reduction in mortality rate with zofenopril did not achieve statistical significance versus ramipril [OR: 0.75 (0.36-1.59), P = 0.459]. These results were in line with those achieved during the initial 1-year follow-up. Benefits of early treatment of patients with LVD after acute myocardial infarction with zofenopril are sustained over many years as compared to ramipril.
|Numero di pagine||7|
|Rivista||Journal of Cardiovascular Pharmacology|
|Stato di pubblicazione||Published - 2017|
All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
Novo, S., Ambrosio, G., Vinereanu, D., Omboni, S., Ambrosioni, E., & Borghi, C. (2017). Early Treatment with Zofenopril and Ramipril in Combination with Acetyl Salicylic Acid in Patients with Left Ventricular Systolic Dysfunction after Acute Myocardial Infarction: Results of a 5-Year Follow-up of Patients of the SMILE-4 Study. Journal of Cardiovascular Pharmacology, 69, 298-304.