Abstract 3781: Long-Term Effect of Perindopril on Coronary Atherosclerosis Progression: Results from the Multicenter, Randomized PERindopril’s Prospective Effect on Coronary aTherosclerosis by Angiography and IntraVascular Ultrasound Evaluation (PERSPECTIVE) Study, an EUROPA Substudy
Background: The EUROPA trial, a double-blind, multicenter trial in 12,218 patients has shown that the long-term administration of 8 mg/day of perindopril induces a significant reduction in adverse clinical events in patients with established CHD.
Objective: The PERSPECTIVE study, a substudy of the EUROPA Trial, was designed to evaluate the effect of long-term administration of perindopril on coronary plaque progression as assessed by quantitative angiography (QCA) and intravascular ultrasound (IVUS).
Methods: The Perspective study evaluated 244 patients (mean age 57 yrs, 81 % male). Evaluable paired QCA was obtained from 194 patients, 96 patients randomized to perindopril and 98 patients to placebo. Concomitant treatment at baseline consisted of aspirin (90%) lipid-lowering agents (70%) and β-blockers (60%) The primary endpoint was the difference of minimum (MinLD) and mean (MeanLD) lumen diameter (QCA) measured at baseline and 3-year follow-up between the perindopril and placebo groups. The difference of mean plaque cross-sectional area (PCSA) between groups (IVUS) was a pre-specified secondary endpoint.
Results: After a median follow-up of 3.0 (range 1.9, 4.1) years, no statistically significant differences in change of QCA measurements were detected between perindopril and placebo groups [MinLD (−0.07±0.4 mm vs. −0.02±0.4 mm, p= 0.34) and of MeanLD (−0.05±0.2 mm vs −0.05±0.3 mm, p= 0.89)] Also the mean absolute reduction in PCSA was not significantly different between perindopril and placebo groups (−0.18±1.2 mm2 vs. −0.02±1.2 mm2, p= 0.48).
Conclusion: We did not demonstrate a significant effect on progression of CAD as assessed by QCA and IVUS of Long-term administration of perindopril patients on concomitant intensive medical treatment.