Zofenopril It is a sulfhydryl-containing, lipophilic ACE inhibitor with a very high affinity for cardiac ACE. It shows some physical and chemical properties, features of pharmacodynamics and pharmakokinetics which are absent in other drugs of this class. Most clinical value have high lipophilicity, which is associated with the prolonged effect of tissue ACE inhibition, antioxidant activity and cardioprotective properties. Sufficient experience of zofenopril application is presently accumulated in different cardiovascular diseases. Zofenopril is an effective antihypertensive ACE inhibitor that has been shown to improve blood pressure control in international placebo controlled randomised clinical trials and was effective as antihypertensives of other basic classes. In preclinical studies the sulfhydryl-group–containing ACE inhibitor zofenopril significantly reduced the frequency and severity of exertional and spontaneous cardiac ischemia. The anti-ischemic and cardioprotective effects of zofenopril have been confermed by the results of randomized controlled studies carried out under the SMILE program in patients with myocardial infarction. In the SMILE study, the early administration of zofenopril in nonthrombolyzed patients with myocardial infarction has been shown to reduce the incidence of death or severe congestive heart failure. The results of the SMILE-ISCHEMIA study extend the use of zofenopril in terms of cardioprotection and prevention of coronary events from the early to the late phase of myocardial infarction. In light of these results, zofenopril may be recommended as a secondary prevention drug treatment in post–myocardial infarction patients with coronary artery disease.