Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study)

Fox, Keith

doi:10.1016/s0140-6736(03)14286-9

Cited by 1,708 publications

(205 citation statements)

References 26 publications

Supporting

Mentioning

180

Contrasting

Unclassified

Order By: Relevance

“…This is similar to, and in contrast to, other trials on patients with coronary artery disease 29, 30, 31. In a meta‐analysis32 based on the 3 cited trials on patients with coronary artery disease, a significant reduction in stroke rate was observed, although this was mainly driven by one of the trials, the Heart Outcomes Prevention Evaluation (HOPE) trial 29.…”

Section: Discussionsupporting

confidence: 70%

Angiotensin‐Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers Are Associated With Improved Outcome but Do Not Prevent New‐Onset Atrial Fibrillation After Acute Myocardial Infarction

Batra

Lindhagen²,

Andell

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundTreatment with renin‐angiotensin system (RAS) inhibitors might restrain the structural/electrical remodeling associated with atrial fibrillation (AF). Limited evidence exists regarding the potential benefits of RAS inhibition post‐acute myocardial infarction (AMI) in patients with AF. This study sought to assess the association between RAS inhibition and all‐cause mortality and new‐onset AF in patients with/without congestive heart failure (CHF) post‐AMI.Methods and ResultsPatients hospitalized for AMI between 2006 and 2012 were identified in Swedish registries. Patients were stratified in 4 subgroups; patients with CHF and AF (n=11 489); patients with CHF without AF (n=31 676); patients with AF without CHF (n=10 066); and patients without both CHF and AF (n=59 417). Patients exposed to RAS inhibition were compared to nontreated. Three‐year risk of all‐cause mortality and new‐onset AF was assessed using adjusted Cox regression analyses. At discharge, 83 291 (73.9%) patients received RAS inhibition. RAS inhibition was associated with lower 3‐year risk of all‐cause mortality in CHF patients with AF, adjusted hazard ratio (HR) with 95% CI 0.75 (0.70–0.81), CHF patients without AF, HR 0.65 (0.60–0.69), AF patients without CHF, HR 0.82 (0.75–0.90), and in patients without CHF and AF, HR 0.76 (0.72–0.81), respectively. RAS inhibition was not associated with lower 3‐year risk of new‐onset AF in patients without AF but with/without CHF; HR 0.96 (0.84–1.10) and 1.12 (1.02–1.22), respectively.Conclusions RAS inhibition post‐AMI was associated with lower risk of all‐cause mortality. In patients with/without CHF, RAS inhibition was not associated with lower incidence of new‐onset AF.

show abstract

Section: Discussionsupporting

confidence: 70%

Angiotensin‐Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers Are Associated With Improved Outcome but Do Not Prevent New‐Onset Atrial Fibrillation After Acute Myocardial Infarction

Batra

Lindhagen²,

Andell

et al. 2017

JAHA

View full text Add to dashboard Cite

show abstract

“…The first trial was called Heart Outcomes Prevention Evaluation (HOPE) and in this trial ramipril reduced both mortality and cardiovascular events in coronary artery disease (CAD) patients [19]. Second, the European Trial on Reduction of Cardiac Events with Perindopril in Stable Coronary Artery Disease (EUROPA) demonstrated that perindopril significantly lowered the incidence of a combined cardiovascular endpoint, consisting of death, myocardial infarction or cardiac arrest [20]. Third, the Prevention of Events with Angiotensin-Converting Enzyme Inhibition (PEACE) trial concluded that trandolapril did not influence cardiovascular outcome or mortality [21].…”

Section: Clinical Effects Of Ace Inhibitorsmentioning

confidence: 99%

The Renin-Angiotensin-Aldosterone System: Approaches to Guide Angiotensin-Converting Enzyme Inhibition in Patients with Coronary Artery Disease

et al. 2008

View full text Add to dashboard Cite

Drugs that modulate the renin-angiotensin-aldosterone system (RAAS) play an important role in modern cardiovascular prevention strategies. Inhibitors of the RAAS, in particular angiotensin-converting enzyme (ACE) inhibitors, have been proven to be beneficial in specific patient groups, including patients with hypertension, heart failure, diabetes mellitus and stable coronary artery disease. Although clinical trials demonstrated a rather consistent beneficial effect of ACE inhibitors across groups of patients based on clinical characteristics, the variability in treatment response on the individual patient level is extensive. Recent publications suggest that genetic polymorphisms in the RAAS are related to cardiovascular risk. Genetic variability also seems associated with the response to ACE inhibitor therapy, and can probably be used to tailor treatment. This review discusses several approaches to guide ACE inhibitor therapy in patients with coronary artery disease. In addition, the potential impact of pharmacogenetics regarding this particular topic is highlighted.

show abstract

“…The EUROPA trial (European trial on reduction of cardiac events among patients with stable coronary artery disease) was conducted in patients with stable coronary artery disease without LV dysfunction, and who were on background antianginal therapy including b-blockers, aspirin, and statins. Perindopril treatment was associated with 20% relative risk reduction in cardiovascular death, MI, or cardiac arrest, compared to placebo [19]. The HOPE trial (the heart outcomes prevention evaluation study) showed 22% relative risk reduction in primary endpoint (composite of MI, stroke, and cardiovascular death) with ramapril in a high risk population [20].…”

Section: Ace Inhibitors and Angiotensin Receptor Blockers (Arbs)mentioning

confidence: 99%

Review of Medical Treatment of Stable Ischemic Heart Disease

Mobeirek¹,

Albackr²,

Shamiri³

et al. 2014

IJCM

View full text Add to dashboard Cite

Medical treatment is the initial treatment strategy and is the cornerstone of management in patients with stable ischemic heart disease (IHD). Many patients are not suitable for percutaneous or surgical revascularization because of unfavourable anatomy, or the presence of co-morbidities. In addition, many patients have recurrence of angina following revascularization due to restenosis or incomplete revascularization. Furthermore, randomized clinical trials comparing optimal medical treatment to revascularization have not clearly shown that myocardial revascularization is superior to optimal medical treatment. Traditional drugs for angina treatment include bblockers, calcium channel blockers and nitrates. Newer drugs are available with different mechanisms of action and with equal efficacy that do not cause significant hemodynamic deterioration. The availability of these newer drugs expands the therapeutic potential of medical treatment to even a wider population with stable IHD. Revascularization in patients with stable ischemic heart disease has never been shown to reduce hard endpoints (death or myocardial infarction) in randomized clinical trials.

show abstract

Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study)

Cited by 1,708 publications

References 26 publications

Angiotensin‐Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers Are Associated With Improved Outcome but Do Not Prevent New‐Onset Atrial Fibrillation After Acute Myocardial Infarction

Angiotensin‐Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers Are Associated With Improved Outcome but Do Not Prevent New‐Onset Atrial Fibrillation After Acute Myocardial Infarction

The Renin-Angiotensin-Aldosterone System: Approaches to Guide Angiotensin-Converting Enzyme Inhibition in Patients with Coronary Artery Disease

Review of Medical Treatment of Stable Ischemic Heart Disease

Contact Info

Product

Resources

About