PERTINENT—PERindopril–Thrombosis, InflammatioN, Endothelial Dysfunction and Neurohormonal Activation Trial

A Sub-Study of the EUROPA Study

Address for correspondence: Roberto Ferrari, Chair of Cardiology, University of Ferrara, Arcispedale Sant'Anna, Corso Giovecca 203, 44100, Ferrara, Italy. Tel.: +39(0532)242 011; Fax: +39(0532)241 885; E-mail: [email protected]

Cardiovascular Drugs & Therapy 17(1):p 83-91, January 2003.

Summary

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 12231 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.