6/28/23, 10:07 PM EUROPA Pathway Feedback Search Clinical Topics Home Studies EUROPA EUROPA Disease Coronary artery disease Trial question What is the role of perindopril in patients with stable coronary heart disease without apparent HF? Study design Multi-center Double blinded RCT Population Characteristics of study participants 14.6% female N = 13655 85.4% male 13655 patients (1779 female, 10439 male) Inclusion criteria: patients with stable coronary heart disease without apparent HF Key exclusion criteria: clinical evidence of HF, planned revascularization, hypotension, uncontrolled hypertension, recent (< 1 month) use of ACE inhibitors or angiotensin-receptor blockers, renal insufficiency, and serum potassium > 5.5 mmol/L Interventions N=6110 perindopril (8 mg PO once daily) N=6108 placebo (matching placebo daily) Primary outcome Cardiovascular death, myocardial infarction, or cardiac arrest 10 10.0 % 8 https://web.pathway.md/studies/rec9sK4VzWVWNTgR0 1/2 6/28/23, 10:07 PM EUROPA Pathway 8 7.5 % 5.0 % Significant decrease 2.5 % NNT = 50 0.0 % Perindopril Placebo Significant decrease in cardiovascular death, myocardial infarction, or cardiac arrest (8% vs. 10%; HR 0.8, 95% CI 0.71 to 0.91) Secondary outcomes Significant decrease in total death, nonfatal MI, unstable angina, cardiac arrest (14.8% vs. 17.1%; RR 0.87, 95% CI 0.79 to 0.94) Safety outcomes No significant difference in withdrawal from treatment (22.8% vs. 20.7%). Significant difference in cough (2.7% vs. 0.5%) and hypotension (1.0% vs. 0.3%). Conclusion In patients with stable coronary heart disease without apparent HF, perindopril was superior to placebo with respect to cardiovascular death, myocardial infarction, or cardiac arrest. Reference Fox KM, EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet. 2003 Sep 6;362(9386):782-8. Open reference URL https://web.pathway.md/studies/rec9sK4VzWVWNTgR0 2/2