Table 1.
Summary of EUROPA trial
| Inclusion criteria: Men and women, aged >18 years, with CHD (previous MI, PCI, CABG, or angiographic evidence*), and without clinical evidence of heart failure. Men were also recruited if they had a history of chest pain and a positive ECG, echocardiograph, or nuclear stress test. |
| Exclusion criteria: Clinical evidence of heart failure, planned revascularization, hypotension (SBP <110 mm Hg), uncontrolled hypertension (SBP >180 mm Hg, DBP >100 mm Hg, or both), recent use of ACEI or ARB, creatinine >0.15 mmol/L, serum potassium >5.5 mmol/L. |
| Primary outcome: composite of cardiovascular death, non-fatal MI, and cardiac arrest with successful resuscitation. |
| Secondary outcomes: composite of total mortality, non-fatal MI, hospital admission for unstable angina, and cardiac arrest with successful resuscitation; cardiovascular mortality and non-fatal MI, as well as individual components of these secondary outcomes and revascularization, stroke, and admission for heart failure. |
| Data derived from EUROPA 2003. |
| Baseline clinical characteristics | Perindopril (n=6110) | Placebo (n=6108) |
|---|---|---|
| Age, years (SD) | 60 (9) | 60 (9) |
| Female sex | 14.5% | 14.7% |
| History of CHD | ||
| MI | 64.9% | 64.7% |
| PCI | 29.0% | 29.5% |
| CABG | 29.3% | 29.4% |
| Documented CHD | ||
| Angiographic evidence* | 60.4% | 60.5% |
| Positive stress test† | 22.6% | 23.3% |
| Previous stroke or TIA | 3.4% | 3.3% |
| Peripheral vascular disease | 7.1% | 7.4% |
| Hypertension‡ | 27.0% | 27.2% |
| Diabetes mellitus | 11.8% | 12.8% |
| Hypercholesterolemia§ | 63.3% | 63.3% |
| Medication | ||
| Platelet inhibitors | 91.9% | 92.7% |
| Lipid-lowering therapy | 57.8% | 57.3% |
| β blockers | 62.0% | 61.3% |
| Calcium-channel blockers | 31.7% | 31.0% |
| Nitrates | 42.8% | 43.0% |
| Diuretics | 9.1% | 9.4% |
| SBP (SD) | 137 (16) | 137 (15) |
*
Angiographic evidence of CHD: stenosis > 70%.
†
Positive stress test: only in men.
‡
Hypertension: BP > 160/95mm Hg or receiving antihypertensive treatment.
§
Hypercholesterolemia: cholesterol > 6.5 mmol/L or receiving lipidlowering treatment.
Abbreviations: ACEI, angiotensin converting enzyme inhibitor; ARB, angiotensin type 1 receptor blocker; CABG, coronary artery bypass graft; CHD, coronary heart disease; DBP, diastolic blood pressure; ECG, electrocardiograph; PCI, percutaneous coronary intervention, MI, myocardial infarction; SBP, systolic blood pressure; SD, standard deviation; TIA, transient ischemic attack.