Prevention of Events With Angiotensin-Converting Enzyme Inhibitor Therapy (PEACE)
Condition: Cardiovascular Diseases; Coronary Disease; Heart Diseases; Myocardial Infarction; Myocardial Ischemia
MeSH terms: Cardiovascular Diseases; Heart Diseases; Myocardial Infarction; Coronary Disease; Myocardial Ischemia; Infarction; Ischemia
Study type: Interventional
Phase: Phase 3

Summary: 
      To determine whether the addition of angiotensin converting enzyme (ACE) inhibitor to
      standard therapy in patients with known coronary artery disease and preserved left
      ventricular function will prevent cardiovascular mortality and reduce the risk of myocardial
      infarction.
    

Detailed description: 
      BACKGROUND:

      Individuals with coronary artery disease are at heightened risk for major cardiovascular
      events. With current advances, a larger segment of our population is manifesting coronary
      artery disease at a more advanced age. The majority of these individuals have preserved left
      ventricular function. Prior studies with converting enzyme inhibitor (CEI) therapy in
      patients with depressed ejection fraction have demonstrated that their long-term
      administration leads to improved survival and reduced risk of myocardial infarction over and
      above conventional therapy. There is sufficient rationale and experience to indicate that
      these benefits will apply to the larger group of individuals with coronary artery disease and
      preserved left ventricular function and therefore have even broader public health
      implications. A definitive trial is needed to assess the capacity of CEI therapy to prevent
      mortality and reduce the risk of myocardial infarction in patients with coronary disease and
      preserved left ventricular function.

      The initiative was proposed by the former Clinical Trials Branch staff and given concept
      clearance at the May 1994 National Heart, Lung, and Blood Advisory Council. The Request for
      Proposals was released in October 1994.

      DESIGN NARRATIVE:

      A multicenter, randomized clinical trial. There are approximately 180 centers in the United
      States, Canada, Puerto Rico, and Italy. Patients are randomly assigned to treatment groups in
      which the addition of the angiotensin-converting enzyme (ACE) inhibitor trandolapril is
      compared to standard therapy. The primary endpoint includes a reduction in the incidence of
      cardiovascular death, nonfatal myocardial infarction, or the need for coronary
      revascularization (PTCA or CABG) in coronary artery disease patients with left ventricular
      ejection fraction of 40 percent or more. Secondary endpoints include the incidence of
      hospitalization for the management of either unstable angina, congestive heart failure,
      stroke, or cardiac arrhythmia. Recruitment started in November 1996 and ended in June 2000
      with a minimum follow-up of five years.
    

Intervention name(s): angiotensin-converting enzyme inhibitors
Intervention type(s): Drug
Intervention MeSH terms: Enzyme Inhibitors; Angiotensin-Converting Enzyme Inhibitors
Allocation: Randomized
Masking: Double
Primary purpose: Prevention