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Title: Patients on Perindopril Have 20% Reduced Mortality in EUROPA Trial: Presented at ESC(CARD)

"Patients on Perindopril Have 20% Reduced Mortality in EUROPA Trial: Presented at ESC(CARD)"

By Ed Susman VIENNA, AUSTRIA -- September 2, 2003 -- Patients with stable heart disease -- angina or a previous heart attack -- can reduce their relative risk of dying of heart disease by 20% if they take the angiotensin-converting enzyme (ACE) inhibitor perindopril. Researchers presented the results of the landmark, 12,218-patient, 4-year EUROPA (European Trial on Reduction of Cardiac Events with Perindopril in Stable Coronary Artery Disease) here August 31st during the European Society of Cardiology. "If all patients were to add perindopril to their standard optimal drug therapy over a 4-year period," said Kim Fox, MD, professor of medicine, Royal Brompton Hospital, London, United Kingdom, "we would stop 250,000 heart attacks or cardiovascular deaths in the United States." The researchers said that it would be possible to prevent one cardiovascular death, one non-fatal myocardial infarction or one cardiac arrest by using perindopril in 50 patients who have a history of angina or a previous heart attack. He said that EUROPA is the first study to demonstrate the efficacy and safety of angiotensin-converting enzyme (ACE) inhibition in a broach spectrum of patient with stable coronary disease. Patients, recruited from 525 centers in 24 countries were assigned to receive perindopril 8 mg once a day or placebo for 48 months. They \ were examined at 3, 6 and 12 months during the first year and then every 6 months after that. The last examinations were conducted in April 2003 at which time the average duration of treatment was four years. In the study, about 9% of patients on perindopril experienced the primary trial end point -- cardiovascular death, a non-fatal heart attack or cardiac arrest -- compared with 12% of those patients that had placebo added to other standard medication. The 3% absolute decline translates to a highly significant 20% reduction in relative risk of experiencing that combination end point, Dr. Fox said. "The results of EUROPA represent a milestone in cardiology," he said, "proving for the very first time the life-saving benefits of an ACE inhibitor – perindopril -- in this patient population. This is a major step forward and will have important implications in the future management of coronary disease. Dr. Willem Remme, MD, who co-chaired the study with Dr. Fox, and is based at "Sticares" Cardiovascular Research Institute, Rhoon, The Netherlands, said, "For the first time we have a drug that not only treats hypertension, an important cardiovascular risk factor, but also improves the outcome of patients with coronary disease. "We now have sufficient evidence to show that perindopril should be used to treat all patients with angina pectoris, history of heart attacks and other evidence of coronary disease, regardless of their hypertensive status." [Study title: Effects of an angiotensin-converting enzyme inhibitor, perindopril, on cardiovascular events in stable coronary artery disease patients (EUROPA). Abstract Hot Line I]

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