EUROPA study on perindopril

EUROPA study on perindopril

In the Europa study [1] on perindopril, an angiotensin converting enzyme inhibitor, 12218 patients with stable coronary artery disease participated. Initially 13655 patients were registered of whom 64% had previous myocardial infarction 61% had angiographic evidence of coronary artery disease, 55% had undergone coronary revascularisation and 5% had only a positive stress test. In the initial run in period of 4 weeks, all of them received perindopril. After that 12218 were randomized to perindopril 8 mg (6110) or matching placebo (6108).
The mean follow-up period was 4.2 years. The primary endpoint was cardiovascular death, myocardial infarction or cardiac arrest. 92% of the subjects were on anti-platelet, 62% on beta blockers and 58% on lipid-lowering drugs. There was a 20% relative risk reduction for primary endpoint (p=0.0003)in the study group. The study recommended that perindopril should be considered in all patients with coronary artery disease on top of other preventive medications. 50 patients need to be treated with perindopril for a period of 4 years to prevent one major cardiovascular event as per the data from this study (number needed to be treated or NNT).

Reference

1. Fox KM; EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. 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). Lancet. 2003 Sep 6;362(9386):782-8.