The effect of perindopril on cardiovascular morbidity and mortality in patients with diabetes in the EUROPA study: results from the PERSUADE substudy.
OBJECTIVE
The aim of this study was to assess the effect of the angiotensin converting enzyme inhibitor perindopril on cardiovascular events in diabetic patients with coronary artery disease.


RESULTS
A total of 1502 diabetic patients with known coronary artery disease and without heart failure of 12 218 overall in the EUropean trial on Reduction Of cardiac events with Perindopril in stable coronary Artery (EUROPA) disease were randomized in a double-blinded manner to perindopril 8 mg once daily or placebo. Follow-up was for a median of 4.3 years. The primary end point was cardiovascular death, non-fatal myocardial infarction, and resuscitated cardiac arrest. Perindopril treatment was associated with a non-significant reduction in the primary endpoint in the diabetic population, 12.6 vs. 15.5%, relative risk reduction 19% [(95% CI, -7 to 38%), P=0.13]. This was of similar relative magnitude to the 20% risk reduction observed in the main EUROPA population.


CONCLUSIONS
Perindopril tends to reduce major cardiovascular events in diabetic patients with coronary disease in addition to other preventive treatments and the trend towards reduction was of a similar relative magnitude to that observed the general population with coronary artery disease.
Daly
Caroline A
CA
Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
Fox
Kim M
KM
Remme
Willem J
WJ
Bertrand
Michel E
ME
Ferrari
Roberto
R
Simoons
Maarten L
ML
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000401:mortality; D016757:Death, Sudden, Cardiac / Q000209:etiology; D003925:Diabetic Angiopathies / Q000188:drug therapy* / Q000401:mortality; D004311:Double-Blind Method; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D020913:Perindopril / Q000627:therapeutic use*; D011446:Prospective Studies
D000806:Angiotensin-Converting Enzyme Inhibitors; D020913:Perindopril