Back to Journals » Vascular Health and Risk Management » Volume 4 » Issue 3

Effects of early treatment with zofenopril in patients with myocardial infarction and metabolic syndrome: the SMILE Study

Authors Borghi C, Cicero AFG, Ambrosioni E

Published 6 June 2008 Volume 2008:4(3) Pages 665—671

DOI https://doi.org/10.2147/VHRM.S2799



Claudio Borghi, Arrigo FG Cicero, Ettore Ambrosioni

Department of Clinical Medicine, University of Bologna, Bologna, Italy. On behalf of the Survival of Myocardial Infarction Long-term Evaluation (SMILE) Study

Objective: To evaluate the clinical efficacy of the early administration of zofenopril in a group of patients with and without metabolic syndrome (MS+ and MS–) and anterior myocardial infarction enrolled in the Survival of Myocardial Infarction Long-Term Evaluation (SMILE) Study.

Methods: Patients were randomized double-blind to zofenopril (n = 719) or placebo (n = 699) 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. The secondary end point was the 1-year mortality rate.

Results: Of the 1418 patients included in this post-hoc analysis, 686 (48.3%) had MS. After 6 weeks of treatment zofenopril significantly reduced the incidence of all-cause death and severe congestive failure (risk reduction: 69%, 95% CI: 7–78; 2p = 0.002) in MS+ patients. This was the case for 1-year mortality, too (29%, 95% CI: 4–41; 2p = 0.048). Zofenopril was effective also in MS− patients but the amount of relative risk reduction was less than in MS+ for both the primary (–11%; 2p = 0.61) and secondary endpoint (–19%; 2p = 0.025).

Conclusions: Results of this post-hoc analysis of the SMILE Study demonstrate the striking benefit of early administration of zofenopril in MS+ patients with acute anterior myocardial infarction.

Keywords: SMILE Study, angiotensin converting enzyme inhibitor, zofenopril, myocardial infarction, metabolic syndrome

Creative Commons License © 2008 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.