An ACE Against Attacks
EUROPA finds 20-percent reduction in cardiovascular events with perindopril
VIENNA
Major cardiology study published by The Lancet suggests that the angiotensin-converting enzyme (ACE) inhibitor perindopril (Coversyl) could lower the risk of major cardiovascular illness and death among people with coronary heart disease-including those deemed to be at low risk.
Authors of the study found that perindopril was effective in addition to other well-known therapies such as aspirin, beta-blockers, and statins.
Cardiovascular disease is the leading cause of death in many parts of the world, mainly in the form of coronary heart disease, despite therapeutic advances using aspirin, statins, and beta-blockers. Treatment with ACE inhibitors reduces the rate of cardiovascular events among patients with left-ventricular dysfunction and those at high risk of such events.
The EURopean trial On reduction of cardiac events with Perindopril in patients with stable coronary Artery disease (EUROPA) study assessed whether perindopril reduced cardiovascular risk in a low-risk population. Over 12,000 patients with coronary artery disease from several European countries were randomly assigned perindopril 8mg once daily or placebo and followed up for an average of just over four years.
Of the total patients, 65 percent had
a previous heart attack, 61 percent had angiographically proven coronary artery disease, and 55 percent had coronary revascularization.
Results bared at the European Society of Cardiology conference in Vienna in late August found that patients given perindopril on top of standard treatment had a 20-percent lower risk of cardiovascular death, heart attack, and cardiac arrest.
Fewer patients (488 or eight percent) given perindopril died from cardiovascular causes or had heart attacks compared with those given placebo (603, or 10 percent). About 92 percent of patients were taking platelet inhibitors, 62 percent beta-blockers, and 58 percent lipid-lowering therapy.
EUROPA cochair Kim Fox of the Royal Brompton Hospital in London said that among patients with stable coronary heart disease without apparent heart failure, perindopril can significantly improve outcome.
"About 50 patients need to be treated for a period of four years to prevent one major cardiovascular event. Treatment with perindopril, on top of other preventive medications, should be considered in all patients with coronary heart disease," he added.
He described the results as "a milestone in cardiology," as they proved the life-saving benefits of an ACE inhibitor.
As their name suggests, ACE inhibitors work by blocking the action of the enzyme responsible for converting angiotensin 1 to angiotensin 2. Angiotensin 2 increases peripheral resistance by vasoconstriction.
Perindopril is manufactured by the French pharmaceutical firm Servier, which funded the study.
|
