THE EUROPEAN TRIAL ON REDUCTION OF CARDIAC EVENTS WITH PERINDOPRIL INSTABLE CORONARY-ARTERY DISEASE (EUROPA)

Background Angiotensin-converting enzyme (ACE) inhibitors have an acce pted place in the treatment of hypertension and heart failure. However , at present they have no specific role in the prevention or treatment of coronary artery disease: evidence from animal experiments and some of the large ACE inhibitor cardiac studies makes this effect well wor th testing. Objective The objective of EUROPA is to assess the effects of perindopril (an ACE inhibitor) on outcome in patients with stable coronary artery disease, but no clinical heart failure. Methods This i s a double-blind, placebo-controlled, multicentre study with a duratio n of 3.5 years. It is proposed to recruit 10 500 patients from 24 coun tries in Europe. The primary end-point is a combined one: total mortal ity, non-fatal acute myocardial infarction, unstable angina pectoris a nd cardiac arrest with successful resuscitation are included; the outc ome is studied in patients with proven coronary artery disease and no clinical heart failure. Secondary end-points consist of these events i ndividually calculated. The first patient was recruited in October 199 7, and it is planned to finish recruitment by the end of 1998.