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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Ther+Clin+Risk+Manag
2018 ; 14
(ä): 1185-1190
Nephropedia Template TP
gab.com Text
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English Wikipedia
Efficacy of zofenopril in combination with thiazide diuretics in patients with
acute myocardial infarction: a pooled individual data analysis of four
randomized, double-blind, controlled, prospective studies
#MMPMID30022831
Borghi C
; Omboni S
; Reggiardo G
; Bacchelli S
; Esposti DD
; Ambrosioni E
Ther Clin Risk Manag
2018[]; 14
(ä): 1185-1190
PMID30022831
show ga
BACKGROUND: In the Survival of Myocardial Infarction Long-Term Evaluation (SMILE)
studies, early administration of zofenopril after acute myocardial infarction
(AMI) was prognostically beneficial as compared to placebo and other
angiotensin-converting enzyme inhibitors (ACEIs), such as lisinopril and
ramipril. Here, we investigated whether zofenopril efficacy could be affected by
a concomitant use of thiazide diuretics (TDs). METHODS: This was a post hoc
analysis of pooled individual patient data from the SMILE studies. Patients
treated with other diuretics than TDs were excluded. The primary study endpoint
was the 1-year combined occurrence of death or hospitalization for CV causes,
with or without TD. RESULTS: Among 2,995 patients, 263 (8.8%) were treated with a
combination including a TD (TD+), whereas 2,732 (91.2%) were not treated with any
diuretic (TD-). Proportions of subjects who were treated with TD were equally
distributed (p=0.774) within the placebo, zofenopril, and other ACEIs groups. The
1-year risk of major cardiovascular events was similar in TD+ (18.3%) and TD-
(16.8%) patients (hazard ratio [HR] 1.04; 95% CI 0.74-1.45; p=0.838). After
stratifying per concomitant treatment and TD, the 1-year risk of CV events was
significantly lower with zofenopril than with placebo (HR 0.70; 95% CI 0.55-0.88;
p=0.002) and other ACEIs (HR 0.58; 95% CI 0.46-0.74; p=0.0001). Treatment with
ACEIs and TD as concomitant therapy was associated with a larger blood pressure
(BP) reduction (p=0.0001 for systolic BP and p=0.045 for diastolic BP).
CONCLUSION: In post AMI patients, zofenopril maintained its positive impact on
prognosis compared to placebo or other ACEIs, regardless concomitant TD
administration. In this setting, TD shows advantages in managing the most
difficult hypertensive patients.