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Treatment benefit by perindopril in patients with stable coronary artery disease at different levels of risk.
Eur Heart J. 2006 Apr; 27(7):796-801.EH

Abstract

AIMS

Patients with stable coronary artery disease (CAD) are at increased risk. Estimation of individual risk is difficult. We developed a cardiovascular risk model based on the EUROPA study population and investigated whether benefit of long-term administration of the angiotensin-converting enzyme (ACE)-inhibitor perindopril was modified by risk level.

METHODS AND RESULTS

A total of 12 218 patients with stable CAD were treated with 8 mg perindopril or placebo. Baseline patient characteristics were assessed for association with 1091 cardiovascular deaths or non-fatal myocardial infarction (MI). Risk factors were age over 65 years, male gender [hazard ratio (HR) 1.2], previous MI (HR 1.5), previous stroke and/or peripheral vascular disease (HR 1.7), diabetes, smoking, angina (all HR 1.5), and high serum cholesterol and systolic blood pressure. Treatment benefit by perindopril was consistent among high, intermediate, and low risk patients (HRs 0.88, 0.68, and 0.83, respectively). Risk reduction was thus not modified by absolute risk level.

CONCLUSION

Risk factors such as age, male gender, smoking, total cholesterol, and blood pressure continue to play an important role once clinical sequellae of coronary heart disease have developed. Patients at moderate-to-high risk because of uncontrolled risk factors and those with other indications for ACE-inhibitors have the most to gain from ACE-inhibition.

Authors+Show Affiliations

Department of Cardiology, Thoraxcenter, Erasmus University Medical Center Rotterdam, The Netherlands. j.deckers@erasmusmc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

16497685

Citation

Deckers, Jaap W., et al. "Treatment Benefit By Perindopril in Patients With Stable Coronary Artery Disease at Different Levels of Risk." European Heart Journal, vol. 27, no. 7, 2006, pp. 796-801.
Deckers JW, Goedhart DM, Boersma E, et al. Treatment benefit by perindopril in patients with stable coronary artery disease at different levels of risk. Eur Heart J. 2006;27(7):796-801.
Deckers, J. W., Goedhart, D. M., Boersma, E., Briggs, A., Bertrand, M., Ferrari, R., Remme, W. J., Fox, K., & Simoons, M. L. (2006). Treatment benefit by perindopril in patients with stable coronary artery disease at different levels of risk. European Heart Journal, 27(7), 796-801.
Deckers JW, et al. Treatment Benefit By Perindopril in Patients With Stable Coronary Artery Disease at Different Levels of Risk. Eur Heart J. 2006;27(7):796-801. PubMed PMID: 16497685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment benefit by perindopril in patients with stable coronary artery disease at different levels of risk. AU - Deckers,Jaap W, AU - Goedhart,Dick M, AU - Boersma,Eric, AU - Briggs,Andrew, AU - Bertrand,Michel, AU - Ferrari,Roberto, AU - Remme,Willem J, AU - Fox,Kim, AU - Simoons,Maarten L, Y1 - 2006/02/23/ PY - 2006/2/25/pubmed PY - 2006/8/1/medline PY - 2006/2/25/entrez SP - 796 EP - 801 JF - European heart journal JO - Eur. Heart J. VL - 27 IS - 7 N2 - AIMS: Patients with stable coronary artery disease (CAD) are at increased risk. Estimation of individual risk is difficult. We developed a cardiovascular risk model based on the EUROPA study population and investigated whether benefit of long-term administration of the angiotensin-converting enzyme (ACE)-inhibitor perindopril was modified by risk level. METHODS AND RESULTS: A total of 12 218 patients with stable CAD were treated with 8 mg perindopril or placebo. Baseline patient characteristics were assessed for association with 1091 cardiovascular deaths or non-fatal myocardial infarction (MI). Risk factors were age over 65 years, male gender [hazard ratio (HR) 1.2], previous MI (HR 1.5), previous stroke and/or peripheral vascular disease (HR 1.7), diabetes, smoking, angina (all HR 1.5), and high serum cholesterol and systolic blood pressure. Treatment benefit by perindopril was consistent among high, intermediate, and low risk patients (HRs 0.88, 0.68, and 0.83, respectively). Risk reduction was thus not modified by absolute risk level. CONCLUSION: Risk factors such as age, male gender, smoking, total cholesterol, and blood pressure continue to play an important role once clinical sequellae of coronary heart disease have developed. Patients at moderate-to-high risk because of uncontrolled risk factors and those with other indications for ACE-inhibitors have the most to gain from ACE-inhibition. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/16497685/Treatment_benefit_by_perindopril_in_patients_with_stable_coronary_artery_disease_at_different_levels_of_risk_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehi809 DB - PRIME DP - Unbound Medicine ER -