ABSTRACT: The SMILE-4 study showed that in patients with left ventricular dysfunction (LVD) following acute myocardial infarction (AMI), early treatment with zofenopril plus acetyl salicylic acid (ASA) is associated with an improved 1-year survival, free from death or hospitalization for cardiovascular (CV) causes, as compared to ramipril plus ASA. We now report on CV outcomes during a 5-year follow-up of the patients of the SMILE-4 study. 386 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 end-point 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, CI: 0.65 (0.43, 0.98), p=0.041]. Such a result was achieved through a significantly larger reduction in cardiovascular 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 vs. 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 following AMI with zofenopril is sustained over many years as compared to ramipril.

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

BORGHI, CLAUDIO;AMBROSIONI, ETTORE
2017

Abstract

ABSTRACT: The SMILE-4 study showed that in patients with left ventricular dysfunction (LVD) following acute myocardial infarction (AMI), early treatment with zofenopril plus acetyl salicylic acid (ASA) is associated with an improved 1-year survival, free from death or hospitalization for cardiovascular (CV) causes, as compared to ramipril plus ASA. We now report on CV outcomes during a 5-year follow-up of the patients of the SMILE-4 study. 386 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 end-point 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, CI: 0.65 (0.43, 0.98), p=0.041]. Such a result was achieved through a significantly larger reduction in cardiovascular 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 vs. 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 following AMI with zofenopril is sustained over many years as compared to ramipril.
2017
Borghi, Claudio; Omboni, Stefano; Novo, Salvatore; Vinereanu, Dragos; Ambrosio, Giuseppe; Ambrosioni, Ettore
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/596191
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