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PERTINENT--perindopril-thrombosis, inflammation, endothelial dysfunction and neurohormonal activation trial: a
Insights
This study investigates how perindopril affects cardiovascular risk markers in coronary artery disease patients. It aims to clarify the role of these markers in disease progression and treatment effectiveness.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Pharmacology
Background:
- Cardiovascular diseases are associated with increased risk from markers of thrombosis, inflammation, endothelial dysfunction, and neurohumoral activation.
- Key markers include fibrinogen, D-dimer, C-reactive protein, von Willebrand factor, tumor necrosis factor-alpha, and chromogranin-A.
Purpose of the Study:
- To evaluate the effect of perindopril, an angiotensin converting enzyme inhibitor, on cardiovascular risk markers in patients with coronary artery disease.
- To investigate the predictive role of C-reactive protein and von Willebrand factor in cardiovascular events.
- To elucidate the pathophysiology of cardiovascular events and the role of perindopril.
Main Methods:
- The PERTINENT sub-study is part of the EUROPA trial, a double-blind, placebo-controlled study of 12,231 patients.
- Part A (300 patients) assesses perindopril's influence on various biomarkers, including endothelial function and apoptosis.
- Part B (1200 patients) uses matched case-control analyses to determine the predictive value of C-reactive protein and von Willebrand factor for cardiovascular events.
Main Results:
- Blood analyses are currently in progress across four specialized laboratories.
- Results are pending and will contribute to understanding the study's objectives.
Conclusions:
- The PERTINENT sub-study is expected to provide insights into the mechanisms underlying cardiovascular events in coronary artery disease.
- Findings may clarify the therapeutic role of perindopril in managing these conditions.
Background:
Markers of thrombosis, inflammation, endothelial dysfunction and neurohumoral activation such as fibrinogen, D-dimer, C-reactive protein, von Willebrand factor, tumour necrosis factor-alpha and chromogranin-A are reported to be linked to the increase of cardiovascular risk for atherosclerosis progression and events in patients with cardiovascular diseases.
Methods:
EUROPA is a double blind, placebo-controlled trial on 12,231 patients that evaluates the effect of an angiotensin converting enzyme inhibitor--perindopril--on prevention of cardiovascular events in patients with coronary artery disease. PERTINENT is a sub-study of EUROPA that evaluates (a) in Part A (300 patients): the influence of perindopril vs. placebo on fibrinogen, D-dimer, C-reactive protein, von Willebrand factor, tumour necrosis factor-alpha and chromogranin-A. In addition, NOS expression and induction of apoptosis on human umbilical vein endothelial cells and angiotensin converting enzyme levels are also studied; (b) in Part B (about 1200 patients): the predictive role of plasma levels of C-reactive protein and von Willebrand factor on the occurrence of cardiovascular events. To this end, matched case-control analyses are planned (patients with vs. patients without events). STATUS OF PERTINENT: Blood analyses are in progress in four specialised laboratories: (a) Gaubius Laboratory, Leiden, TNO-PG, The Netherlands; (b) University Department of Medicine, Birmingham, UK; (c) University of Pavia, Italy; (d) Fondazione Salvatore Maugeri, Cardiovascular Research Centre, Gussago, Italy.
Conclusions:
The PERTINENT sub-study might help elucidating the phenomena contributing to the pathophysiology of cardiovascular events in patients with coronary artery disease and the role of perindopril in such context.
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