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.

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. [10.1016/j.ahj.2006.02.022]

Effects of early angiotensin-converting enzyme inhibition in patients with non-ST-elevation acute anterior myocardial infarction

Mattioli AV
Membro del Collaboration Group
2006

Abstract

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.
2006
152
3
470
477
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. [10.1016/j.ahj.2006.02.022]
Borghi, C.; Bacchelli, S.; Esposti, D. D.; Ambrosioni, E.; Mattioli, Av
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1185037
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