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标题：Effects of early treatment with zofenopril in patients with myocardial infarction and metabolic syndrome: the SMILE Study
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作者：Claudio Borghi ; Arrigo FG Cicero ; Ettore Ambrosioni 等
期刊名称：Vascular Health and Risk Management
印刷版ISSN：1176-6344
电子版ISSN：1178-2048
出版年度：2008
卷号：4
期号：3
页码：665-671
DOI：10.2147/VHRM.S2799
出版社：Dove Medical Press Ltd
摘要：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.
关键词：SMILE Study; angiotensin converting enzyme inhibitor; zofenopril; myocardial infarction; metabolic syndrome