Кардіопротекторні ефекти зофеноприлу: механізми реалізації та клінічне значення

The aim – to analyze and summarize experimental and clinical data on the cardio- and vasoprotective mechanisms of zofenopril and to determine its clinical significance in patients with high cardiovascular riskAn analytical review of the literature on the antioxidant, anti-ischemic, and anti-inflammatory effects of zofenopril was conducted. The results of the long-term SMILE clinical research program, which investigated the effect of zofenopril on the course of acute myocardial infarction, left ventricular dysfunction, and myocardial ischemia, were also analyzed. Zofenopril exhibits pronounced antioxidant activity, reducing oxidative stress and free oxygen radicals. By increasing the bioavailability of NO and H2S, it mitigates ischemic damage, improves endothelial function, and enhances vasodilation. Zofenopril inhibits atherosclerosis progression, prevents intimal hyperplasia, reduces ischemia–reperfusion injury of the myocardium, and positively affects arterial stiffness. In a series of SMILE clinical trials, zofenopril was shown to reduce both hospitalization rates and mortality in patients following acute myocardial infarction, including those with left ventricular dysfunction. Compared with other ACE inhibitors, zofenopril is characterized by a favorable safety profile and additional cardioprotective benefits.Conclusions. The combination of antioxidant, anti-ischemic, and anti-inflammatory properties makes zofenopril an effective and safe agent for the treatment of arterial hypertension and ischemic heart disease. The use of zofenopril improves long-term outcomes and quality of life in these patients.