Zofenopril and Ramipril in Combination with Acetyl Salicylic Acid in Postmyocardial Infarction Patients with Left Ventricular Systolic Dysfunction: A Retrospective Analysis of the SMILE-4 Randomized, Double-Blind Study in Diabetic Patients

Salvatore Novo, Dei Cas Livio, Giuseppe Ambrosio, Tamburino Corrado, Pop Calin, Cardoso Silva, Romero Fernández, Diaz, Miccoli Federico, Agrusta Marco, Salerno Uriarte Jorge, Avenirovitch Kostenko Victor, Castello Antonio, Caso Pio, Dorobantu Maria, Andrade Aurora, Sergeevich Moiseev Valentin, Raviele Antonio, Cipolla Tommaso, Evola RosarioFattore Luciano, Barsotti Antonio, Mikhailovich Goloschekin Boris, Cinteza Mircea, Fiscella Antonio, Manitiu Ioan, Yurievich Vishnevsky Alexander, Ural Komsuoglu Dilek, Arsenescu Georgescu Catalina, Lvovich Syrkin Abram, Marte Filippo, Di Pasquale Paolo, Gaspardone Achille, Porcu Maurizio, Ankindinovna Koval Olena, Marenzi Giancarlo, Ferrante Raffaele, Caliendo Luigi, Alexopolulus Dimitrios, Bergerone Serena, Marchionni Niccoló, De Nittis Giuseppe, Tuccillo Bernardino, Petrovich Vakalyuk Igor, Nikolaevich Tereschenko Sergey, Orlandi Mario, Mikhaylovich Nifontov Evgeniy, Ionescu Dominic, Vasquez Ludovico, Borisovich Karpov Yuriy, Ielasi Giuseppe, Noussan Patrizia, Trinchero Rita, Ortan Florin, Kirma Cevat, Nikolaevna Burova Natalia, Renaldini Emiliano, Nanas Ioannis, Nikolayevich Zrazhevsky Konstantin, Moreira Joseà Ilidio, Piovaccari Giancarlo, Radoi Mariana, Vladimirovich Batushkin Valerii, Iosifovna Tseluiko Vira, Alexandrovich Vasyuk Yuriy, Pavlovich Arutuynov Grigory, Nikolaevich Parkhomenko Alexan, Victorovich Rudenko Leonid, Oğuzhan Abdurrahman, Tihonovich Vatutin Mykola, Terrosu Pierfranco, Testa Roberto, Villani Giovanni Quinto, Meral Kayikcioglu, Alvés Mario Garcia, Storti Giovanni, Dragos Vinereanu, Cianflone Domenico, Stefano Omboni, Presbitero Patrizia, De Ferrari Gaetano, Ettore Ambrosioni, Claudio Borghi

    Risultato della ricerca: Article

    2 Citazioni (Scopus)

    Abstract

    Objective: In the SMILE-4 study, zofenopril + acetyl salicylic acid (ASA) was more effective than ramipril + ASA on 1-year prevention of major cardiovascular events (MACE) in patients with acute myocardial infarction complicated by left ventricular dysfunction. In this retrospective analysis, we evaluated drug efficacy in subgroups of patients, according to a history of diabetes mellitus. Methods: The primary study endpoint was 1-year combined occurrence of death or hospitalization for cardiovascular causes. Diabetes was defined according to medical history (previous known diagnosis). Results: A total of 562 of 693 (81.0%) patients were classified as nondiabetics and 131 (18.9%) as diabetics. The adjusted rate of MACE was lower under zofenopril than under ramipril in both nondiabetics [27.9% vs. 34.9% ramipril; odds ratio, OR and 95% confidence interval: 0.55 (0.35, 0.86)] and diabetics [30.9% vs. 41.3%; 0.56 (0.18, 1.73)], although the difference was statistically significant only for the nondiabetic group (P = 0.013). Zofenopril was superior to ramipril as regards to the primary study endpoint in the subgroup of 157 patients with uncontrolled blood glucose (≥126 mg/dL), regardless of a previous diagnosis of diabetes [0.31 (0.10, 0.90), P = 0.030]. Zofenopril significantly reduced the risk of hospitalization for cardiovascular causes in both nondiabetics [0.64 (0.43, 0.96), P = 0.030] and diabetics [0.38 (0.15, 0.95), P = 0.038], whereas it was not better than ramipril in terms of prevention of cardiovascular deaths. Conclusions: This retrospective analysis of the SMILE-4 study confirmed the good efficacy of zofenopril plus ASA in the prevention of long-term MACE also in the subgroup of patients with diabetes mellitus.
    Lingua originaleEnglish
    pagine (da-a)76-84
    Numero di pagine9
    RivistaCardiovascular Therapeutics
    Volume34
    Stato di pubblicazionePublished - 2016

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    All Science Journal Classification (ASJC) codes

    • Pharmacology
    • Cardiology and Cardiovascular Medicine
    • Pharmacology (medical)

    Cita questo

    Novo, S., Livio, D. C., Ambrosio, G., Corrado, T., Calin, P., Silva, C., Fernández, R., Diaz, Federico, M., Marco, A., Jorge, S. U., Victor, A. K., Antonio, C., Pio, C., Maria, D., Aurora, A., Valentin, S. M., Antonio, R., Tommaso, C., ... Borghi, C. (2016). Zofenopril and Ramipril in Combination with Acetyl Salicylic Acid in Postmyocardial Infarction Patients with Left Ventricular Systolic Dysfunction: A Retrospective Analysis of the SMILE-4 Randomized, Double-Blind Study in Diabetic Patients. Cardiovascular Therapeutics, 34, 76-84.