New considerations relating to class effect with angiotensin-converting enzyme inhibitors--the PEACE study

Area of Science:

• Cardiology
• Pharmacology

Background:

• Angiotensin-converting enzyme (ACE) inhibitor therapy is recognized for cardiovascular benefits in various conditions like heart failure and hypertension.
• A class effect for ACE inhibitors in cardiovascular protection has been suggested, supported by multiple drug observations.

Purpose of the Study:

• To evaluate the additional benefit of trandolapril, an ACE inhibitor, in patients with stable coronary artery disease and preserved left ventricular function.
• To investigate whether adding trandolapril to standard therapy reduces cardiovascular events in this population.

Main Methods:

• The study involved patients with stable coronary artery disease and preserved left ventricular function.
• Trandolapril was added to the contemporary therapeutic regimen of these patients.

Main Results:

• The addition of trandolapril did not significantly reduce the incidence of cardiovascular death.
• Myocardial infarction and coronary revascularization rates were not improved by the addition of trandolapril.
• The trial yielded neutral findings regarding additional cardiovascular protection.

Conclusions:

• The findings suggest that trandolapril does not provide additional cardiovascular benefits in patients with stable coronary artery disease and preserved left ventricular function.
• These neutral results question the universal class effect of ACE inhibitors for cardiovascular protection in all coronary artery disease patients.