Background No data are available on the clinical efficacy of the early administration (< 24 hours from onset of chest pain) of angiotensin-converting enzyme inhibitors in non-thrombolysed patients with non-ST-elevation myocardial infarction (NSTEMI). We have addressed this issue in a subgroup of NSTEMI patients enrolled in the SMILE trial.Methods Of the overall population of 1556 patients, 526 (33.8%) had an anterior wall NSTEMI, defined as an ST elevation < 1 mm or an ST depression in at least two contiguous precordial leads with or without new abnormal Q waves. No patient of the SMILE Study received thrombolytic therapy or was reperfused. Patients were randomized, double-blind, to zofenopril (n = 253) or placebo (n = 273) 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 (CHF). Secondary end points included the evaluation of the 6-week rate of severe CHIF as well as the 1-year mortality rate.Results After 6 weeks of treatment, zofenopril significantly reduced both the incidence of the primary end point.(risk reduction 65%, 95% Cl 20-80, 2P =.003) and the 6-week incidence of severe CHF (84%, 95% CI 33-97, 2P = .006) in NSTEMI patients. One-year mortality was also significantly reduced by zofenopril treatment (43%, 95% CI 14-57, 2P = .036).Conclusions Results of this post hoc analysis of the SMILE Study strongly suggest the benefit of the early administration of zofenopril even in patients with an anterior wall NSTEMI.
|Data di pubblicazione:||2006|
|Titolo:||Effects of early angiotensin-converting enzyme inhibition in patients with non-ST-elevation acute anterior myocardial infarction|
|Autore/i:||Borghi, C.; Bacchelli, S.; Esposti, D. D.; Ambrosioni, E.; Mattioli, Av|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.ahj.2006.02.022|
|Codice identificativo ISI:||WOS:000240564800014|
|Codice identificativo Scopus:||2-s2.0-33747155938|
|Codice identificativo Pubmed:||16923416|
|Citazione:||Effects of early angiotensin-converting enzyme inhibition in patients with non-ST-elevation acute anterior myocardial infarction / Borghi, C.; Bacchelli, S.; Esposti, D. D.; Ambrosioni, E.; Mattioli, Av. - In: AMERICAN HEART JOURNAL. - ISSN 0002-8703. - 152:3(2006), pp. 470-477.|
|Tipologia||Articolo su rivista|
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