Why the study?
Does perindopril reduce a composite outcome of cardiovascular death, nonfatal myocardial infarction or resuscitated cardiac arrest in patients with stable coronary artery disease without apparent heart failure?
Does perindopril reduce a composite outcome of cardiovascular death, nonfatal myocardial infarction or resuscitated cardiac arrest in patients with stable coronary artery disease without apparent heart failure?
Perindopril provides direct vascular protection and reduces cardiac events in patients with stable coronary artery disease without heart failure, including those revascularized or with preserved LVEF.
May support perindopril in stable CAD without HF; leaves open optimal use amid modern therapies.
The European Trial on Reduction of Cardiac Events with Perindopril in Stable Coronary Artery Disease (EUROPA) investigated the effect of angiotensin-converting enzyme inhibition on the prevention of cardiac events in patients with stable coronary artery disease (CAD) without apparent heart failure. Perindopril 8 mg/day significantly reduced a composite outcome of cardiovascular death, nonfatal myocardial infarction or resuscitated cardiac arrest by 20% compared with placebo, in addition to standard preventive therapies. This review describes the substudies and subpopulation analyses carried out within the EUROPA population, concluding that the benefits of perindopril extend to all stable CAD patients, even revascularized patients or those with preserved left ventricular function. Data on the pathophysiological mechanisms underlying CAD indicate direct vascular protection with perindopril. This helps explain why perindopril is beneficial in preventing cardiac events in stable CAD patients.
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Ferrari et al. (2007) studied this question.
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