Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction
Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction Claudio Borghi , MD , Stefano Bacchelli , MD , Daniela Degli Esposti , MD , Ettore Ambrosioni , MD and on behalf of the SMILE Study Investigators From the Department of Internal Medicin...
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| Veröffentlicht in: | Diabetes care 2003-06, Vol.26 (6), p.1862-1868 |
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| creator | BORGHI, Claudio BACCHELLI, Stefano DEGLI ESPOSTI, Daniela AMBROSIONI, Ettore |
| description | Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction
Claudio Borghi , MD ,
Stefano Bacchelli , MD ,
Daniela Degli Esposti , MD ,
Ettore Ambrosioni , MD and
on behalf of the SMILE Study Investigators
From the Department of Internal Medicine, University of Bologna, Bologna, Italy
Abstract
OBJECTIVE —The aim of the present study was to evaluate the clinical efficacy of the ACE inhibitor zofenopril in a cohort of diabetic
patients with nonthrombolyzed anterior acute myocardial infarction who were enrolled in the Survival of Myocardial Infarction
Long-Term Evaluation (SMILE) trial.
RESEARCH DESIGN AND METHODS —Among the overall population of 1,512 patients, 303 (20.0%) had diabetes. The primary end point of this study 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 major cardiovascular events as well as the 1-year survival rate.
RESULTS —After 6 weeks of double-blind treatment, zofenopril significantly reduced both the incidence of the primary end point (8.6
vs. 18.3%; P = 0.019) and the 6-week incidence of severe CHF (0 vs. 7.3%; P = 0.001) in diabetic patients, and the effect was greater than that observed in nondiabetic patients. Conversely, 1-year
mortality was significantly reduced among nondiabetic patients (9.1 vs. 13.8%; P = 0.010), whereas in the diabetic population, the decrease did not reach statistical significance (13.7 vs. 16.5%; P = 0.52).
CONCLUSIONS —The present data suggest that the clinical outcome of patients with diabetes and myocardial infarction can be significantly
improved by early treatment with zofenopril. The lesser effect on 1-year mortality seems to suggest that long-term treatment
is probably needed to maintain the benefits of the early ACE inhibition in patients with diabetes.
AMI, acute myocardial infarction
CHF, congestive heart failure
GISSI-3, Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico
LV, left ventricular
MI, myocardial infarction
NNT, number needed to treat
SMILE, Survival of Myocardial Infarction Long-term Evaluation
TRACE, Trandolapril Cardiac Evaluation
Footnotes
Address correspondence and reprint requests to Claudio Borghi, MD, Divisione di Medicina Interna-Ambrosioni, Policlinico S.
Orsola Via Massarenti 9, 40138 Bologna, Italy. E-mail: claudio{at}med.unibo.it .
Received for publication 19 Novembe |
| doi_str_mv | 10.2337/diacare.26.6.1862 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_gale_infotracacademiconefile_A102724406</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A102724406</galeid><sourcerecordid>A102724406</sourcerecordid><originalsourceid>FETCH-LOGICAL-c509t-26111882895dd34fa3241f16e5a3a08d26ca81d06daf7a552e6154df9a94bf133</originalsourceid><addsrcrecordid>eNptkd2LEzEUxQdR3HX1D_BFgqAPwtR8TTrzWGrVhfXjQfEx3CY3nSzTZDdJkfrXm9rCgpT7cOHyO-ceOE3zktEZF2L-3nowkHDG1UzNWK_4o-aSDaJru072j5tLyuTQdsPAL5pnOd9SSqXs-6fNBeNzpRiXl01aOYemZBIdKSOSFaRpTxbLFbkOo1_74mMgPpAPHtZYvCFfYyhjitt1nPZ_0JLvUDyGavDLl5EsQsHkYyILsytIvuxjDVhjTtXOQTIHu-fNEwdTxhenfdX8_Lj6sfzc3nz7dL1c3LSmo0NpuWKM9T3vh85aIR0ILpljCjsQQHvLlYGeWaosuDl0HUfFOmndAINcOybEVfP26HuX4v0Oc9Fbnw1OEwSMu6znQlDJmazg6__A27hLoWbTnFeGUcUr1B6hDUyofXCxJDAbDJhgigGdr-cFo3zOpaSq8rMzfB2LW2_OCthRYFLMOaHTd8lvIe01o_pQtz7VrbnSSh_qrppXp-S79Rbtg-LUbwXenADIBiaXIBifHzjZS6HkgXt35Ea_GX_7-sT-Kxzzma9_AZCnwcU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>223041062</pqid></control><display><type>article</type><title>Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>BORGHI, Claudio ; BACCHELLI, Stefano ; DEGLI ESPOSTI, Daniela ; AMBROSIONI, Ettore</creator><creatorcontrib>BORGHI, Claudio ; BACCHELLI, Stefano ; DEGLI ESPOSTI, Daniela ; AMBROSIONI, Ettore ; SMILE Study ; on behalf of the SMILE Study Investigators</creatorcontrib><description>Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction
Claudio Borghi , MD ,
Stefano Bacchelli , MD ,
Daniela Degli Esposti , MD ,
Ettore Ambrosioni , MD and
on behalf of the SMILE Study Investigators
From the Department of Internal Medicine, University of Bologna, Bologna, Italy
Abstract
OBJECTIVE —The aim of the present study was to evaluate the clinical efficacy of the ACE inhibitor zofenopril in a cohort of diabetic
patients with nonthrombolyzed anterior acute myocardial infarction who were enrolled in the Survival of Myocardial Infarction
Long-Term Evaluation (SMILE) trial.
RESEARCH DESIGN AND METHODS —Among the overall population of 1,512 patients, 303 (20.0%) had diabetes. The primary end point of this study 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 major cardiovascular events as well as the 1-year survival rate.
RESULTS —After 6 weeks of double-blind treatment, zofenopril significantly reduced both the incidence of the primary end point (8.6
vs. 18.3%; P = 0.019) and the 6-week incidence of severe CHF (0 vs. 7.3%; P = 0.001) in diabetic patients, and the effect was greater than that observed in nondiabetic patients. Conversely, 1-year
mortality was significantly reduced among nondiabetic patients (9.1 vs. 13.8%; P = 0.010), whereas in the diabetic population, the decrease did not reach statistical significance (13.7 vs. 16.5%; P = 0.52).
CONCLUSIONS —The present data suggest that the clinical outcome of patients with diabetes and myocardial infarction can be significantly
improved by early treatment with zofenopril. The lesser effect on 1-year mortality seems to suggest that long-term treatment
is probably needed to maintain the benefits of the early ACE inhibition in patients with diabetes.
AMI, acute myocardial infarction
CHF, congestive heart failure
GISSI-3, Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico
LV, left ventricular
MI, myocardial infarction
NNT, number needed to treat
SMILE, Survival of Myocardial Infarction Long-term Evaluation
TRACE, Trandolapril Cardiac Evaluation
Footnotes
Address correspondence and reprint requests to Claudio Borghi, MD, Divisione di Medicina Interna-Ambrosioni, Policlinico S.
Orsola Via Massarenti 9, 40138 Bologna, Italy. E-mail: claudio{at}med.unibo.it .
Received for publication 19 November 2002 and accepted in revised form 25 January 2003.
C.B. and E.A. have received honoraria from the Menarini Company for speaking engagements on ACE inhibitors.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
DIABETES CARE</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/diacare.26.6.1862</identifier><identifier>PMID: 12766124</identifier><identifier>CODEN: DICAD2</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>ACE inhibitors ; Aged ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Antihypertensive agents ; Biological and medical sciences ; Captopril - analogs & derivatives ; Captopril - therapeutic use ; Cardiovascular system ; Congestive heart failure ; Creatine Kinase - blood ; Diabetes ; Diabetes Complications ; Diabetes Mellitus - epidemiology ; Diabetics ; Double-Blind Method ; Drug therapy ; Evaluation ; Female ; Health aspects ; Heart attack ; Heart attacks ; Heart Failure - epidemiology ; Humans ; Italy ; Male ; Medical sciences ; Middle Aged ; Mortality ; Myocardial Infarction - drug therapy ; Patient outcomes ; Pharmacology. Drug treatments ; Risk Factors ; Smoking ; Survival Analysis ; Time Factors</subject><ispartof>Diabetes care, 2003-06, Vol.26 (6), p.1862-1868</ispartof><rights>2003 INIST-CNRS</rights><rights>COPYRIGHT 2003 American Diabetes Association</rights><rights>Copyright American Diabetes Association Jun 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-26111882895dd34fa3241f16e5a3a08d26ca81d06daf7a552e6154df9a94bf133</citedby><cites>FETCH-LOGICAL-c509t-26111882895dd34fa3241f16e5a3a08d26ca81d06daf7a552e6154df9a94bf133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14843644$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12766124$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BORGHI, Claudio</creatorcontrib><creatorcontrib>BACCHELLI, Stefano</creatorcontrib><creatorcontrib>DEGLI ESPOSTI, Daniela</creatorcontrib><creatorcontrib>AMBROSIONI, Ettore</creatorcontrib><creatorcontrib>SMILE Study</creatorcontrib><creatorcontrib>on behalf of the SMILE Study Investigators</creatorcontrib><title>Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction
Claudio Borghi , MD ,
Stefano Bacchelli , MD ,
Daniela Degli Esposti , MD ,
Ettore Ambrosioni , MD and
on behalf of the SMILE Study Investigators
From the Department of Internal Medicine, University of Bologna, Bologna, Italy
Abstract
OBJECTIVE —The aim of the present study was to evaluate the clinical efficacy of the ACE inhibitor zofenopril in a cohort of diabetic
patients with nonthrombolyzed anterior acute myocardial infarction who were enrolled in the Survival of Myocardial Infarction
Long-Term Evaluation (SMILE) trial.
RESEARCH DESIGN AND METHODS —Among the overall population of 1,512 patients, 303 (20.0%) had diabetes. The primary end point of this study 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 major cardiovascular events as well as the 1-year survival rate.
RESULTS —After 6 weeks of double-blind treatment, zofenopril significantly reduced both the incidence of the primary end point (8.6
vs. 18.3%; P = 0.019) and the 6-week incidence of severe CHF (0 vs. 7.3%; P = 0.001) in diabetic patients, and the effect was greater than that observed in nondiabetic patients. Conversely, 1-year
mortality was significantly reduced among nondiabetic patients (9.1 vs. 13.8%; P = 0.010), whereas in the diabetic population, the decrease did not reach statistical significance (13.7 vs. 16.5%; P = 0.52).
CONCLUSIONS —The present data suggest that the clinical outcome of patients with diabetes and myocardial infarction can be significantly
improved by early treatment with zofenopril. The lesser effect on 1-year mortality seems to suggest that long-term treatment
is probably needed to maintain the benefits of the early ACE inhibition in patients with diabetes.
AMI, acute myocardial infarction
CHF, congestive heart failure
GISSI-3, Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico
LV, left ventricular
MI, myocardial infarction
NNT, number needed to treat
SMILE, Survival of Myocardial Infarction Long-term Evaluation
TRACE, Trandolapril Cardiac Evaluation
Footnotes
Address correspondence and reprint requests to Claudio Borghi, MD, Divisione di Medicina Interna-Ambrosioni, Policlinico S.
Orsola Via Massarenti 9, 40138 Bologna, Italy. E-mail: claudio{at}med.unibo.it .
Received for publication 19 November 2002 and accepted in revised form 25 January 2003.
C.B. and E.A. have received honoraria from the Menarini Company for speaking engagements on ACE inhibitors.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
DIABETES CARE</description><subject>ACE inhibitors</subject><subject>Aged</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Antihypertensive agents</subject><subject>Biological and medical sciences</subject><subject>Captopril - analogs & derivatives</subject><subject>Captopril - therapeutic use</subject><subject>Cardiovascular system</subject><subject>Congestive heart failure</subject><subject>Creatine Kinase - blood</subject><subject>Diabetes</subject><subject>Diabetes Complications</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Diabetics</subject><subject>Double-Blind Method</subject><subject>Drug therapy</subject><subject>Evaluation</subject><subject>Female</subject><subject>Health aspects</subject><subject>Heart attack</subject><subject>Heart attacks</subject><subject>Heart Failure - epidemiology</subject><subject>Humans</subject><subject>Italy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial Infarction - drug therapy</subject><subject>Patient outcomes</subject><subject>Pharmacology. Drug treatments</subject><subject>Risk Factors</subject><subject>Smoking</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkd2LEzEUxQdR3HX1D_BFgqAPwtR8TTrzWGrVhfXjQfEx3CY3nSzTZDdJkfrXm9rCgpT7cOHyO-ceOE3zktEZF2L-3nowkHDG1UzNWK_4o-aSDaJru072j5tLyuTQdsPAL5pnOd9SSqXs-6fNBeNzpRiXl01aOYemZBIdKSOSFaRpTxbLFbkOo1_74mMgPpAPHtZYvCFfYyhjitt1nPZ_0JLvUDyGavDLl5EsQsHkYyILsytIvuxjDVhjTtXOQTIHu-fNEwdTxhenfdX8_Lj6sfzc3nz7dL1c3LSmo0NpuWKM9T3vh85aIR0ILpljCjsQQHvLlYGeWaosuDl0HUfFOmndAINcOybEVfP26HuX4v0Oc9Fbnw1OEwSMu6znQlDJmazg6__A27hLoWbTnFeGUcUr1B6hDUyofXCxJDAbDJhgigGdr-cFo3zOpaSq8rMzfB2LW2_OCthRYFLMOaHTd8lvIe01o_pQtz7VrbnSSh_qrppXp-S79Rbtg-LUbwXenADIBiaXIBifHzjZS6HkgXt35Ea_GX_7-sT-Kxzzma9_AZCnwcU</recordid><startdate>20030601</startdate><enddate>20030601</enddate><creator>BORGHI, Claudio</creator><creator>BACCHELLI, Stefano</creator><creator>DEGLI ESPOSTI, Daniela</creator><creator>AMBROSIONI, Ettore</creator><general>American Diabetes Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0K</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20030601</creationdate><title>Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction</title><author>BORGHI, Claudio ; BACCHELLI, Stefano ; DEGLI ESPOSTI, Daniela ; AMBROSIONI, Ettore</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c509t-26111882895dd34fa3241f16e5a3a08d26ca81d06daf7a552e6154df9a94bf133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>ACE inhibitors</topic><topic>Aged</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Antihypertensive agents</topic><topic>Biological and medical sciences</topic><topic>Captopril - analogs & derivatives</topic><topic>Captopril - therapeutic use</topic><topic>Cardiovascular system</topic><topic>Congestive heart failure</topic><topic>Creatine Kinase - blood</topic><topic>Diabetes</topic><topic>Diabetes Complications</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Diabetics</topic><topic>Double-Blind Method</topic><topic>Drug therapy</topic><topic>Evaluation</topic><topic>Female</topic><topic>Health aspects</topic><topic>Heart attack</topic><topic>Heart attacks</topic><topic>Heart Failure - epidemiology</topic><topic>Humans</topic><topic>Italy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial Infarction - drug therapy</topic><topic>Patient outcomes</topic><topic>Pharmacology. Drug treatments</topic><topic>Risk Factors</topic><topic>Smoking</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BORGHI, Claudio</creatorcontrib><creatorcontrib>BACCHELLI, Stefano</creatorcontrib><creatorcontrib>DEGLI ESPOSTI, Daniela</creatorcontrib><creatorcontrib>AMBROSIONI, Ettore</creatorcontrib><creatorcontrib>SMILE Study</creatorcontrib><creatorcontrib>on behalf of the SMILE Study Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Agricultural Science Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BORGHI, Claudio</au><au>BACCHELLI, Stefano</au><au>DEGLI ESPOSTI, Daniela</au><au>AMBROSIONI, Ettore</au><aucorp>SMILE Study</aucorp><aucorp>on behalf of the SMILE Study Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2003-06-01</date><risdate>2003</risdate><volume>26</volume><issue>6</issue><spage>1862</spage><epage>1868</epage><pages>1862-1868</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><coden>DICAD2</coden><abstract>Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction
Claudio Borghi , MD ,
Stefano Bacchelli , MD ,
Daniela Degli Esposti , MD ,
Ettore Ambrosioni , MD and
on behalf of the SMILE Study Investigators
From the Department of Internal Medicine, University of Bologna, Bologna, Italy
Abstract
OBJECTIVE —The aim of the present study was to evaluate the clinical efficacy of the ACE inhibitor zofenopril in a cohort of diabetic
patients with nonthrombolyzed anterior acute myocardial infarction who were enrolled in the Survival of Myocardial Infarction
Long-Term Evaluation (SMILE) trial.
RESEARCH DESIGN AND METHODS —Among the overall population of 1,512 patients, 303 (20.0%) had diabetes. The primary end point of this study 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 major cardiovascular events as well as the 1-year survival rate.
RESULTS —After 6 weeks of double-blind treatment, zofenopril significantly reduced both the incidence of the primary end point (8.6
vs. 18.3%; P = 0.019) and the 6-week incidence of severe CHF (0 vs. 7.3%; P = 0.001) in diabetic patients, and the effect was greater than that observed in nondiabetic patients. Conversely, 1-year
mortality was significantly reduced among nondiabetic patients (9.1 vs. 13.8%; P = 0.010), whereas in the diabetic population, the decrease did not reach statistical significance (13.7 vs. 16.5%; P = 0.52).
CONCLUSIONS —The present data suggest that the clinical outcome of patients with diabetes and myocardial infarction can be significantly
improved by early treatment with zofenopril. The lesser effect on 1-year mortality seems to suggest that long-term treatment
is probably needed to maintain the benefits of the early ACE inhibition in patients with diabetes.
AMI, acute myocardial infarction
CHF, congestive heart failure
GISSI-3, Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico
LV, left ventricular
MI, myocardial infarction
NNT, number needed to treat
SMILE, Survival of Myocardial Infarction Long-term Evaluation
TRACE, Trandolapril Cardiac Evaluation
Footnotes
Address correspondence and reprint requests to Claudio Borghi, MD, Divisione di Medicina Interna-Ambrosioni, Policlinico S.
Orsola Via Massarenti 9, 40138 Bologna, Italy. E-mail: claudio{at}med.unibo.it .
Received for publication 19 November 2002 and accepted in revised form 25 January 2003.
C.B. and E.A. have received honoraria from the Menarini Company for speaking engagements on ACE inhibitors.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
DIABETES CARE</abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>12766124</pmid><doi>10.2337/diacare.26.6.1862</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-5992 |
| ispartof | Diabetes care, 2003-06, Vol.26 (6), p.1862-1868 |
| issn | 0149-5992 1935-5548 |
| language | eng |
| recordid | cdi_gale_infotracacademiconefile_A102724406 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | ACE inhibitors Aged Angiotensin-Converting Enzyme Inhibitors - therapeutic use Antihypertensive agents Biological and medical sciences Captopril - analogs & derivatives Captopril - therapeutic use Cardiovascular system Congestive heart failure Creatine Kinase - blood Diabetes Diabetes Complications Diabetes Mellitus - epidemiology Diabetics Double-Blind Method Drug therapy Evaluation Female Health aspects Heart attack Heart attacks Heart Failure - epidemiology Humans Italy Male Medical sciences Middle Aged Mortality Myocardial Infarction - drug therapy Patient outcomes Pharmacology. Drug treatments Risk Factors Smoking Survival Analysis Time Factors |
| title | Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-29T13%3A16%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effects%20of%20the%20Early%20ACE%20Inhibition%20in%20Diabetic%20Nonthrombolyzed%20Patients%20With%20Anterior%20Acute%20Myocardial%20Infarction&rft.jtitle=Diabetes%20care&rft.au=BORGHI,%20Claudio&rft.aucorp=SMILE%20Study&rft.date=2003-06-01&rft.volume=26&rft.issue=6&rft.spage=1862&rft.epage=1868&rft.pages=1862-1868&rft.issn=0149-5992&rft.eissn=1935-5548&rft.coden=DICAD2&rft_id=info:doi/10.2337/diacare.26.6.1862&rft_dat=%3Cgale_proqu%3EA102724406%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=223041062&rft_id=info:pmid/12766124&rft_galeid=A102724406&rfr_iscdi=true |