Serum cholesterol levels on admission and survival in patients with acute myocardial infarction treated with zofenopril: a post hoc analysis of the Survival of Myocardial Infarction Long-term Evaluation trial.
To evaluate the clinical efficacy of early angiotensin-converting enzyme (ACE) inhibition by zofenopril in patients with anterior myocardial infarction and normal or high plasma low density lipoprotein-cholesterolaemia. Post hoc analysis of the Survival of Myocardial Infarction Long-Term Evaluation study, a double-blind, clinical trial including 1400 patients with anterior myocardial infarction, randomized to zofenopril (n = 699, 66% hypercholesterolemics) or placebo (n = 701, 64% hypercholesterolemics) for 6 weeks. The rate of the primary end-point (6-week combined occurrence of death and severe congestive heart failure) was 8.1% in hypercholesterolemic and 6.4% in normocholesterolemic patients (P < 0.03). The favourable effect of treatment with zofenopril was enhanced in hypercholesterolemics patients when compared with normocholesterolemics (RRR = 43%, P = 0.034 vs. 25%, P = 0.19). One-year mortality was 10% in hypercholesterolemic patients vs. 7.5% in normocholesterolemic patients (P = 0.037), equally reduced in both hypercholesterolemic and normocholesterolemics patients by zofenopril. The presence of hypercholesterolaemia in patients with anterior myocardial infarction could be associated with more favourable effects of early ACE-inhibition.
Borghi
Claudio
C
Department of Internal Medicine, Aging and Kidney diseases, University Hospital of Bologna, Bologna, Italy. claudio.borghi@unibo.it
Cicero
Arrigo F G
AF
Bacchelli
Stefano
S
Esposti
Daniela Degli
DD
Ambrosioni
Ettore
E
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008078:Cholesterol, LDL / Q000097:blood*; D003955:Diagnostic Tests, Routine; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000150:complications; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000401:mortality; D011237:Predictive Value of Tests; D013997:Time Factors; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D008078:Cholesterol, LDL; C044958:zofenopril; D002216:Captopril