Cost effectiveness of zofenopril in patients with left ventricular systolic dysfunction after acute myocardial infarction: a post- hoc analysis of the smile-4 study

Borghi, Claudio; Ambrosioni, Ettore; Omboni, Stefano; Cicero, Arrigo Francesco Giuseppe; Bacchelli, Stefano; Esposti, D. Degli; Novo, Salvatore; Vinereanu, Dragoş; Ambrosio, Giuseppe; Reggiardo, Giorgio; Zava, Dario

doi:10.1016/j.jval.2013.03.1487

Cited by 2 publications

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“…24 Selanjutnya, penggunaan zofenopril juga diketahui memiliki biaya efektif pada pasien hipertensi dengan gangguan ventrikular kiri setelah mengalami infark miokard akut. 25 …”

Section: Pembahasanunclassified

Persistensi Penggunaan Obat Antihipertensi pada Pasien Hipertensi Rawat Jalan

Nurmainah

Fudholi

Dwiprahasto

2013

Kesmas: National Public Health Journal

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AbstrakPersistensi penggunaan obat antihipertensi pada pasien hipertensi sangat diperlukan mengingat hasil utama terapi hipertensi adalah mencegah kejadian penyakit kardiovaskular seperti infark miokard, dan stroke yang berujung pada kematian. Penelitian ini bertujuan mengetahui pengaruh jenis terapi dan jenis obat antihipertensi terhadap persistensi. Penelitian ini menggunakan desain studi kohort retrospektif dan menggunakan sumber data sekunder pasien hipertensi rawat jalan peserta asuransi kesehatan PT Askes di RSUD Panembahan Senopati Bantul. Metode pengukuran persistensi adalah metode the gaps between refill dengan tenggang waktu pengambilan obat selama 30 hari. Data dianalisis menggunakan uji kai kuadrat, Kaplan-Meier, dan Cox regression. Jumlah subjek yang ikut dalam penelitian ini adalah 304 pasien hipertensi yang menggunakan obat antihipertensi pertama kali (tanggal indeks diagnosis 1 Juli 2007 hingga 31 Desember 2008). Setelah pengamatan 4,5 tahun, hampir separuh subjek yang mendapat monoterapi (57,6%) dan kombinasi terapi (53,8%) tidak persisten menggunakan obat antihipertensi. Ketidakpersistenan penggunaan obat antihipertensi lebih besar pada kelompok monoterapi daripada kelompok kombinasi, tetapi perbedaan tersebut tidak signifikan (RR = 0,94; 95% CI = 0,73 _ 1,21). Penggunakan diuretik (85,7%) dan kombinasi obat diuretik + ACE inhibitor (84,6%) cenderung tidak persisten dibandingkan subjek yang menggunakan ACE inhibitor (58,4%). Perbedaan ini bermakna secara statistik (RR = 1,47; 95% CI = 1,05 _ 2,01 dan RR = 1,45; 95% CI = 1,10 _ 1,91). Persistensi dipengaruhi oleh jenis obat antihipertensi yang digunakan, yaitu ACE inhibitor. Kata kunci: ACE inhibitor, hipertensi, persistensi AbstractPersistence of the use of antihypertensive drugs in hypertensive patients greatly needed. Considering the primary outcome of treatment for hypertension is to reduce or prevent the occurrence of cardiovascular events such as myocardial infarction, stroke resulting in the risk of death. This Persistensi Penggunaan Obat Antihipertensi pada Pasien Hipertensi Rawat Jalan Persistence of Antihypertensive Drugs among Outpatient with HypertensionNurmainah* Ahmad Fudholi** Iwan Dwiprahasto*** study aims to determine whether persistence is influenced by the type of treatment or type of antihypertensive drugs. This study was designed with retrospective cohort study using database of prescribing claimed of subjects under health insurance (PT Askes) in Panembahan Senopati hospitals using antihypertensive drugs. Persistency measurement method used is the method of the gaps between refilling. The grace period taking the drug for 30 days. Further data were analyzed using the chi square test, Kaplan _ Meier, and Cox regression. This cohort study involving 304 patients using antihypertensive medications first (index diagnosis 1 July 2007 until 31 December 2008). After observation for 4,5 years found almost half of the subjects receive monotherapy (57,6%) or combination therapy (53,8%) are not persistent in the use of antihypertensive m...

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“…24 Selanjutnya, penggunaan zofenopril juga diketahui memiliki biaya efektif pada pasien hipertensi dengan gangguan ventrikular kiri setelah mengalami infark miokard akut. 25 …”

Section: Pembahasanunclassified

Persistensi Penggunaan Obat Antihipertensi pada Pasien Hipertensi Rawat Jalan

Nurmainah

Fudholi

Dwiprahasto

2013

Kesmas: National Public Health Journal

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Efficacy and Safety of Zofenopril Versus Ramipril in the Treatment of Myocardial Infarction and Heart Failure: A Review of the Published and Unpublished Data of the Randomized Double-Blind SMILE-4 Study

et al. 2018

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Zofenopril is a lipophilic, sulfhydryl group-containing angiotensin-converting enzyme (ACE)-inhibitor, characterized by wide tissue distribution, long duration of action, and pleiotropic effects on endothelial dysfunction. Its clinical efficacy and safety have been described in the four randomized controlled trials of the SMILE program, which globally enrolled more than 3600 patients in post-acute myocardial infarction (AMI) setting. The SMILE-4 study specifically selected patients with left ventricular dysfunction at admission, and compared the effects of zofenopril or ramipril in combination with acetylsalicylic acid (ASA). Zofenopril demonstrated its superiority over ramipril in reducing the combined occurrence of death or hospitalization for cardiovascular causes both in the overall population included in the original study and in subgroups of patients at highest risk, namely hypertensive and diabetic subjects. The effects of the early treatment with zofenopril were sustained over time, and, after 5 years of follow-up, zofenopril increased the survival likelihood and reduced the hospitalization rate. Compared to ramipril, zofenopril was cost-effective with a number to treat of 13 and an incremental cost-effectiveness ratio (ICER) of 2125.45 euros for any additional event prevented. Furthermore, in real-world settings, zofenopril decreased the risk of death in patients with heart failure, particularly in men, and in subjects older than 76 years or with ejection fraction lower than 54%. These results support the early use of zofenopril immediately after AMI, even in the presence of comorbidities, and its maintenance over time to reduce the risk of heart failure.Funding: Menarini International Operations Luxembourg S.A.

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Cost effectiveness of zofenopril in patients with left ventricular systolic dysfunction after acute myocardial infarction: a post- hoc analysis of the smile-4 study

Cited by 2 publications

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Persistensi Penggunaan Obat Antihipertensi pada Pasien Hipertensi Rawat Jalan

Persistensi Penggunaan Obat Antihipertensi pada Pasien Hipertensi Rawat Jalan

Efficacy and Safety of Zofenopril Versus Ramipril in the Treatment of Myocardial Infarction and Heart Failure: A Review of the Published and Unpublished Data of the Randomized Double-Blind SMILE-4 Study

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