Key result
Trandolapril fails to reduce CV mortality or MI in the PEACE trial review.
Why the study?
The PEACE trial results conflicted with prior large-scale trials by showing no cardiovascular benefit of trandolapril in stable coronary heart disease, raising questions about ACE inhibitor class effects.
Do all ACE inhibitors act in an identical way in reducing cardiovascular events in patients with stable coronary heart disease?
Do all ACE inhibitors act in an identical way in reducing cardiovascular events in patients with stable coronary heart disease?
This review explores potential reasons for the neutral results of the PEACE trial with trandolapril in stable coronary heart disease, questioning the universal class effect of ACE inhibitors.
Questions class effect of ACE inhibitors in stable CHD; leaves open agent- or trial-specific differences for targeted study.
The results of the Prevention of Events with Angiotensin Converting Enzyme Inhibition (PEACE trial), involving patients with stable coronary heart disease, demonstrated that the angiotensin-converting enzyme (ACE) inhibitor trandolapril did not reduce cardiovascular mortality, or the incidence of fatal or non-fatal myocardial infarction. These results were in conflict with the vast majority of previously published large-scale trials, and could be seen to weaken confidence in ACE inhibitor therapy of ischaemic heart disease. This review article examines the results of PEACE in comparison with the other major trials in terms of the severity of the disease in the patients, the statistical power of the analyses, the doses of the agents used and the concept of a 'class effect' of the ACE inhibitors.
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Stefan Grajek (2005) conducted a review in Stable coronary heart disease. ACE inhibitors (trandolapril) was evaluated. This review examines the PEACE trial results, which found that trandolapril did not reduce cardiovascular mortality or myocardial infarction, in the context of a potential ACE inhibitor class effect.
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