Angiotensin-converting-enzyme inhibition in stable coronary artery disease
Open accessAbstract
Background Angiotensin-converting-enzyme (ACE) inhibitors are effective in reducing the risk of heart failure, myocardial infarction, and death from cardiovascular causes in patients with left ventricular systolic dysfunction or heart failure. ACE inhibitors have also been shown to reduce atherosclerotic complications in patients who have vascular disease without heart failure. Methods In the Prevention of Events with Angiotensin Converting Enzyme Inhibition (PEACE) Trial, we tested the hypothesis that patients with stable coronary artery disease and normal or slightly reduced left ventricular function derive therapeutic benefit from the addition of ACE inhibitors to modern conventional therapy. The trial was a double-blind, placebo-controlled study in which 8290 patients were randomly assigned to receive either trandolapril at a target dose of 4 mg per day (4158 patients) or matching placebo (4132 patients). Results The mean (+/-SD) age of the patients was 64+/-8 years, the mean blood pressure 133+/-17/78+/-10 mm Hg, and the mean left ventricular ejection fraction 58+/-9 percent. The patients received intensive treatment, with 72 percent having previously undergone coronary revascularization and 70 percent receiving lipid-lowering drugs. The incidence of the primary end point--death from cardiovascular causes, myocardial infarction, or coronary revascularization--was 21.9 percent in the trandolapril group, as compared with 22.5 percent in the placebo group (hazard ratio in t…
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ACE inhibitors or ARB therapy have well-established long-term benefit in people with diabetes and CKD or hypertension.
“ACE inhibitors or ARB therapy also have well-established long-term benefit in people with diabetes and CKD or hypertension, and these agents are recommended for hypertension management in people with known ASCVD (particularly coronary artery disease) (72,73,246).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [246]
ACE inhibitors or ARB therapy have well-established long-term benefit in people with diabetes and CKD or hypertension.
“ACE inhibitors or ARB therapy also have well-established long-term benefit in people with diabetes and CKD or hypertension, and these agents are recommended for hypertension management in people with known ASCVD (particularly coronary artery disease) (66,67,238).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [238]
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- Authors
- The PEACE Trial Investigators
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- The PEACE Trial Investigators
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2004-11-11
- Volume
- 351
- Issue
- 20
- Pages
- 2058-2068
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC2556374
- OpenAlex
- W2106244081
- Cited by
- 1,123
- References
- 6
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 12 · 2023: 23 · 2022: 23 · 2021: 25 · 2020: 21 · 2019: 33 · 2018: 27 · 2017: 43 · 2016: 37 · 2015: 43 · 2014: 43 · 2013: 47 · 2012: 69
- FWCI
- 75.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01hc065149-005)
- National Heart, Lung, and Blood Institute (N01 HC065149)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- ACE inhibitors, trandolapril, stable coronary artery disease, preserved left ventricular function, cardiovascular events, myocardial infarction, coronary revascularization, cardiovascular mortality, PEACE trial, secondary prevention
- MeSH terms
- Aged, Angiotensin-Converting Enzyme Inhibitors, Blood Pressure, Cardiovascular Diseases, Coronary Disease, Double-Blind Method, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Indoles, Male, Middle Aged, Myocardial Infarction, Myocardial Revascularization, Renin-Angiotensin System, Ventricular Function, Left
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