Contemporary Heart Failure Therapy: 2026 ESC Updates and the Place of Zofenopril Among RAAS Inhibitors With Potential H₂S-Dependent Cytoprotective Effects

Koval D.S.

Main
Publications
Contemporary Heart Failure Therapy: 2026 ESC Updates and the Place of Zofenopril Among RAAS Inhibitors With Potential H₂S-Dependent Cytoprotective Effects

November 5, 2026

349

Koval D.S.

УДК: УДК 616.12-008.46

DOI: DOI:10.32471/umj.1680-3051.282230

Keywords :

angiotensin-converting enzyme inhibitors,

heart failure,

myocardial infarction,

Zocardis®,

zofenopril

Resume

This article reviews key aspects of the 2026 ESC recommendations on the prevention and treatment of heart failure and the role of renin–angiotensin–aldosterone system inhibition in foundational therapy. The post-myocardial infarction evidence base for zofenopril is summarized. In SMILE-1, early treatment reduced the 6-week incidence of the composite outcome of death or severe heart failure from 10.6% to 7.1%. In SMILE-4, the combination of zofenopril and acetylsalicylic acid reduced the incidence of cardiovascular death or hospitalization compared with ramipril plus acetylsalicylic acid, primarily owing to fewer hospitalizations. The article also describes the principles of zofenopril titration and its potential H₂S-dependent cytoprotective mechanisms.

References

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