title: High prevalence of risk factors in coronary artery disease in EUROPA gives HOPE for ACE inhibitors after PEACE.
abstract: BACKGROUND
  Routine use of ACE inhibitors (ACE-I) as secondary preventive therapy for all patients with coronary artery disease (CAD) is challenged by the PEACE trial. Currently it is unclear to what extent ACE-I should be used in CAD populations.
  
  
  OBJECTIVE
  To analyze the prevalence of left ventricular systolic dysfunction, diabetes, myocardial infarction and hypertension in an unselected and consecutive population of patients with documented CAD and evaluate the potential need for ACE-I treatment in a real-life scenario.
  
  
  METHODS
  We searched a database containing all invasive cardiac investigations in three hospitals in Copenhagen from July 1, 2000 to June 30, 2003. Patients with no angiographic sign of CAD were excluded.
  
  
  RESULTS
  Among 7,345 patients, 4,180 had stable CAD and 3,165 had acute coronary syndrome (ACS). Among the stable CAD patients 78% had at least one of the following indications for treatment with an ACE-I: left ventricular ejection fraction <0.45 (20%), hypertension (39%), diabetes (19%), systolic blood pressure >159 mm Hg (21%), and/or myocardial infarction (42%). Among ACS patients, 90% had an indication for ACE-I treatment.
  
  
  CONCLUSIONS
  Depending on the definitions, at least 78% of the patients with stable CAD and 90% with ACS have an accepted indication for treatment with an ACE-I.
authors.affiliation: Department of Cardiology, Gentofte Hospital, Hellerup, Denmark. sunped01@geh.regionh.dk
authors.forename: Sune A
authors.initials: SA
authors.lastname: Pedersen
authors.forename: Søren
authors.initials: S
authors.lastname: Galatius
authors.forename: Michael Hecht
authors.initials: MH
authors.lastname: Olsen
authors.forename: Bente Kühn
authors.initials: BK
authors.lastname: Madsen
authors.forename: Jan Kyst
authors.initials: JK
authors.lastname: Madsen
authors.forename: Olav W
authors.initials: OW
authors.lastname: Nielsen
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003718:Denmark / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors