ACE inhibition and endothelial function

Main findings of PERFECT, a sub-study of the EUROPA trial

M. L. Bots, W. J. Remme, T. F. Lüscher, K. M. Fox, M. Bertrand, R. Ferrari, M. L. Simoons, D. E. Grobbee, J. Aldershville, P. Hildebrandt, J. P. Bassand, D. Cokkinos, P. Toutouzas, J. Eha, L. Erhardt, J. Erikssen, R. Grybauskas, U. Kalnins, K. Karsch, U. Sechtem & 16 others M. Keltai, W. Klein, T. Luescher, D. Mulcahy, M. Nieminen, A. Oto, O. Ozsaruhan, W. Paulus, L. Providencia, W. J. Remme, I. Riecansky, W. Ruzyllo, U. Santini, L. Tavazzi, J. Soler-Soler, P. Widimsky

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background: ACE inhibition results in secondary prevention of coronary artery disease (CAD) through different mechanisms including improvement of endothelial dysfunction. The Perindopril-Function of the Endothelium in Coronary artery disease Trial (PERFECT) evaluated whether long-term administration of perindopril improves endothelial dysfunction. Methods: PERFECT is a 3-year double blind randomised placebo controlled trial to determine the effect of perindopril 8 mg once daily on brachial artery endothelial function in patients with stable CAD without clinical heart failure. Endothelial function in response to ischaemia was assessed using ultrasound. Primary endpoint was difference in flow-mediated vasodilatation (FMD) assessed at 36 months. Results: In 20 centers, 333 patients randomly received perindopril or matching placebo. Ischemia-induced FMD was 2.7% (SD 2.6). In the perindopril group FMD went from 2.6% at baseline to 3.3% at 36 months and in the placebo group from 2.8 to 3.0%. Change in FMD after 36 month treatment was 0.55% (95% confidence interval -0.36, 1.47; p=0.23) higher in perindopril than in placebo group. The rate of change in FMD per 6 months was 0.14% (SE 0.05, p=0.02) in perindopril and 0.02% (SE 0.05, p=0.74) in placebo group (0.12% difference in rate of change p=0.07). Conclusion: Perindopril resulted in a modest, albeit not statistically significant, improvement in FMD.

Original languageEnglish
Pages (from-to)269-279
Number of pages11
JournalCardiovascular Drugs and Therapy
Volume21
Issue number4
DOIs
Publication statusPublished - Aug 2007

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Perindopril
Endothelium
Coronary Artery Disease
Vasodilation
Placebos
Ischemia
Brachial Artery
Secondary Prevention
Randomized Controlled Trials
Heart Failure
Confidence Intervals

Keywords

  • ACE inhibition
  • Atherosclerosis
  • Brachial reactivity
  • Cardiovascular disease prevention
  • Coronary heart disease
  • Endothelial function

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Cardiology and Cardiovascular Medicine
  • Pharmacology

Cite this

Bots, M. L., Remme, W. J., Lüscher, T. F., Fox, K. M., Bertrand, M., Ferrari, R., ... Widimsky, P. (2007). ACE inhibition and endothelial function: Main findings of PERFECT, a sub-study of the EUROPA trial. Cardiovascular Drugs and Therapy, 21(4), 269-279. https://doi.org/10.1007/s10557-007-6041-3

ACE inhibition and endothelial function : Main findings of PERFECT, a sub-study of the EUROPA trial. / Bots, M. L.; Remme, W. J.; Lüscher, T. F.; Fox, K. M.; Bertrand, M.; Ferrari, R.; Simoons, M. L.; Grobbee, D. E.; Aldershville, J.; Hildebrandt, P.; Bassand, J. P.; Cokkinos, D.; Toutouzas, P.; Eha, J.; Erhardt, L.; Erikssen, J.; Grybauskas, R.; Kalnins, U.; Karsch, K.; Sechtem, U.; Keltai, M.; Klein, W.; Luescher, T.; Mulcahy, D.; Nieminen, M.; Oto, A.; Ozsaruhan, O.; Paulus, W.; Providencia, L.; Remme, W. J.; Riecansky, I.; Ruzyllo, W.; Santini, U.; Tavazzi, L.; Soler-Soler, J.; Widimsky, P.

In: Cardiovascular Drugs and Therapy, Vol. 21, No. 4, 08.2007, p. 269-279.

Research output: Contribution to journalArticle

Bots, ML, Remme, WJ, Lüscher, TF, Fox, KM, Bertrand, M, Ferrari, R, Simoons, ML, Grobbee, DE, Aldershville, J, Hildebrandt, P, Bassand, JP, Cokkinos, D, Toutouzas, P, Eha, J, Erhardt, L, Erikssen, J, Grybauskas, R, Kalnins, U, Karsch, K, Sechtem, U, Keltai, M, Klein, W, Luescher, T, Mulcahy, D, Nieminen, M, Oto, A, Ozsaruhan, O, Paulus, W, Providencia, L, Remme, WJ, Riecansky, I, Ruzyllo, W, Santini, U, Tavazzi, L, Soler-Soler, J & Widimsky, P 2007, 'ACE inhibition and endothelial function: Main findings of PERFECT, a sub-study of the EUROPA trial', Cardiovascular Drugs and Therapy, vol. 21, no. 4, pp. 269-279. https://doi.org/10.1007/s10557-007-6041-3
Bots, M. L. ; Remme, W. J. ; Lüscher, T. F. ; Fox, K. M. ; Bertrand, M. ; Ferrari, R. ; Simoons, M. L. ; Grobbee, D. E. ; Aldershville, J. ; Hildebrandt, P. ; Bassand, J. P. ; Cokkinos, D. ; Toutouzas, P. ; Eha, J. ; Erhardt, L. ; Erikssen, J. ; Grybauskas, R. ; Kalnins, U. ; Karsch, K. ; Sechtem, U. ; Keltai, M. ; Klein, W. ; Luescher, T. ; Mulcahy, D. ; Nieminen, M. ; Oto, A. ; Ozsaruhan, O. ; Paulus, W. ; Providencia, L. ; Remme, W. J. ; Riecansky, I. ; Ruzyllo, W. ; Santini, U. ; Tavazzi, L. ; Soler-Soler, J. ; Widimsky, P. / ACE inhibition and endothelial function : Main findings of PERFECT, a sub-study of the EUROPA trial. In: Cardiovascular Drugs and Therapy. 2007 ; Vol. 21, No. 4. pp. 269-279.
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keywords = "ACE inhibition, Atherosclerosis, Brachial reactivity, Cardiovascular disease prevention, Coronary heart disease, Endothelial function",
author = "Bots, {M. L.} and Remme, {W. J.} and L{\"u}scher, {T. F.} and Fox, {K. M.} and M. Bertrand and R. Ferrari and Simoons, {M. L.} and Grobbee, {D. E.} and J. Aldershville and P. Hildebrandt and Bassand, {J. P.} and D. Cokkinos and P. Toutouzas and J. Eha and L. Erhardt and J. Erikssen and R. Grybauskas and U. Kalnins and K. Karsch and U. Sechtem and M. Keltai and W. Klein and T. Luescher and D. Mulcahy and M. Nieminen and A. Oto and O. Ozsaruhan and W. Paulus and L. Providencia and Remme, {W. J.} and I. Riecansky and W. Ruzyllo and U. Santini and L. Tavazzi and J. Soler-Soler and P. Widimsky",
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T2 - Main findings of PERFECT, a sub-study of the EUROPA trial

AU - Bots, M. L.

AU - Remme, W. J.

AU - Lüscher, T. F.

AU - Fox, K. M.

AU - Bertrand, M.

AU - Ferrari, R.

AU - Simoons, M. L.

AU - Grobbee, D. E.

AU - Aldershville, J.

AU - Hildebrandt, P.

AU - Bassand, J. P.

AU - Cokkinos, D.

AU - Toutouzas, P.

AU - Eha, J.

AU - Erhardt, L.

AU - Erikssen, J.

AU - Grybauskas, R.

AU - Kalnins, U.

AU - Karsch, K.

AU - Sechtem, U.

AU - Keltai, M.

AU - Klein, W.

AU - Luescher, T.

AU - Mulcahy, D.

AU - Nieminen, M.

AU - Oto, A.

AU - Ozsaruhan, O.

AU - Paulus, W.

AU - Providencia, L.

AU - Remme, W. J.

AU - Riecansky, I.

AU - Ruzyllo, W.

AU - Santini, U.

AU - Tavazzi, L.

AU - Soler-Soler, J.

AU - Widimsky, P.

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N2 - Background: ACE inhibition results in secondary prevention of coronary artery disease (CAD) through different mechanisms including improvement of endothelial dysfunction. The Perindopril-Function of the Endothelium in Coronary artery disease Trial (PERFECT) evaluated whether long-term administration of perindopril improves endothelial dysfunction. Methods: PERFECT is a 3-year double blind randomised placebo controlled trial to determine the effect of perindopril 8 mg once daily on brachial artery endothelial function in patients with stable CAD without clinical heart failure. Endothelial function in response to ischaemia was assessed using ultrasound. Primary endpoint was difference in flow-mediated vasodilatation (FMD) assessed at 36 months. Results: In 20 centers, 333 patients randomly received perindopril or matching placebo. Ischemia-induced FMD was 2.7% (SD 2.6). In the perindopril group FMD went from 2.6% at baseline to 3.3% at 36 months and in the placebo group from 2.8 to 3.0%. Change in FMD after 36 month treatment was 0.55% (95% confidence interval -0.36, 1.47; p=0.23) higher in perindopril than in placebo group. The rate of change in FMD per 6 months was 0.14% (SE 0.05, p=0.02) in perindopril and 0.02% (SE 0.05, p=0.74) in placebo group (0.12% difference in rate of change p=0.07). Conclusion: Perindopril resulted in a modest, albeit not statistically significant, improvement in FMD.

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KW - Cardiovascular disease prevention

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