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Coronary Artery Disease
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ACE (Angiotensin Converting Enzyme) inhibitors
ACE inhibitors are commonly used to lower blood pressure. They do this by blocking the action of an enzyme (ACE) that converts the inactive hormone angiotensin I to the active hormone angiotensin II and is also responsible for the degradation of bradykinin. The absence of angiotensin II and increased levels of bradykinin results in a widening of the arteries, thereby causing a fall in blood pressure.

Active treatment
A treatment given to a patient in a study that is pharmacologically active eg, perindopril
8 mg was the active treatment in the EUROPA trial.

Angina / angina pectoris
Usually referred to as simply ‘angina’, this is a recurring pain or discomfort in the chest that happens when some part of the heart does not receive enough blood.

Angiotensin II
A chemical involved in the renin-angiotensin aldosterone system (RAAS), which plays a key role in blood pressure regulation. A high level of angiotensin II is responsible for narrowing blood vessels and raising blood pressure.

The name ‘atherosclerosis’ comes from the Greek words ‘athero’ (meaning gruel or paste) and sclerosis (meaning hardness). It is a process in which the deposits of fatty substances, cholesterol, cellular waste products, calcium and other substances build up in the inner lining of an artery. It usually affects large and medium-sized arteries.

Blood pressure
The pressure of blood against the walls of the main arteries. Blood pressure is measured in millimetres of mercury (mmHg) and is recorded when the ventricles of the heart are contracting (systolic pressure) and relaxing (diastolic pressure).

Bradykinin is a protein found in blood plasma which has a powerful influence in dilating or relaxing the blood vessels, thereby decreasing blood pressure, but also having protective properties on the vessel walls.

Referring to the heart.

Cardiac arrest
A failure of the heart to pump blood, resulting in the loss of effective circulation.

Cardiovascular system
The bodily system consisting of the heart, blood vessels, and blood that circulates through the body, transporting nutrients and oxygen to the tissues and removing waste products.

Something that is of, or relating to, the heart e.g., the coronary arteries supply blood to the muscles of the heart.

Coronary Artery Bypass Graft (CABG)
An operation using arterial or venous conduits inserted between aorta and the coronary artery beyond the narrowing.

Coronary Artery Disease (CAD)
The is the most common form of heart disease, in which the coronary arteries become narrowed or clogged and cannot supply enough blood to the heart.

Coronary Heart Disease (CHD)
See coronary artery disease.

Diastolic pressure
The pressure of blood when the ventricles of the heart are relaxing and refilling. This is when blood pressure is at its lowest.

Double-blind study
An intervention study where two or more groups of patients are deliberately given different treatments and neither the patient or the doctor responsible for the treatment is aware of which treatment is being administered.

A thin monolayer of cells lining the inside of all blood vessels working as a selective barrier with metabolic and secretory activity. Its dysfunction, present in many pathological cases, is implicated in the manifestation of cardiovascular diseases.

EUROPA (European Trial on the Reduction of Cardiac Events with Perindopril in Stable Coronary Artery Disease)
The first study to assess the long-term effects (over four years) of ACE-inhibitor therapy with perindopril on the reduction of cardiac events in patients with proven stable coronary artery disease with/without myocardial ischaemia but without heart failure, irrespective of their age or risk profile.

The effectiveness of a drug.

Heart attack
See myocardial infarction.

Heart failure
An inability of the heart to pump enough blood to sustain normal bodily functions.

High blood pressure
See hypertension.

When the blood pressure goes above the normal range expected in a particular age group.

IntraVascular UltraSound (IVUS)
A method of viewing the coronary arteries by threading a tiny ultrasound ‘camera’ into the coronary arteries to give a valuable cross-sectional view from the inside-out showing a view of the artery wall.

The loss of an adequate supply of oxygenated blood, usually due to obstruction of the arterial blood supply or inadequate blood flow , leading to a lack of oxygen in the tissue and causing serious damage to the end organs (brain, heart, kidney).

The incidence of a disease in a population.

The death rate: the ratio of the total number of deaths to the total population.

Myocardial Infarction (MI)
The medical term for heart attack, which occurs when the blood supply to part of the heart muscle itself – the myocardium – is severely reduced or stopped, resulting in the death of a segment of the heart muscle.

Myocardial ischaemia
A condition where the heart muscle is deprived of oxygen due to poor blood circulation.

Percutaneous Coronary Intervention (PCI)
An intervention with introduction of catheters and balloons to dilate coronary atherosclerotic narrowing.

A medication that belongs to a class of drugs known as angiotensin converting enzyme (ACE) inhibitors. It is very effective and well tolerated, has a long duration of action, and can be given as a once daily dose. Perindopril is indicated in hypertension and heart failure.

Placebo-controlled study
A study where one of the treatments given to patients is inactive i.e., a placebo. This placebo is usually compared with the active treatment being evaluated in the study.

The number of people with a condition in the population at risk at a given point in time.

Quantitative Coronary Angiography (QCA)
QCA is an imaging technology that uses X-rays to view the arteries of the heart in three dimensions. Angiography reveals the status of the coronary arteries and their branches, which supply blood and nutrients to the cells of the heart.

Randomised study
Patients entering the study are randomly assigned to receive a particular treatment. The likelihood of receiving one or other study treatment is identical. This is to avoid any selection bias that may affect the impartiality of the study results.

Renin-Angiotensin Aldosterone System (RAAS)
The RAAS is a critical component in regulating blood pressure and fluid balance in the body. Evidence suggests that it is also involved in the development of atherosclerosis.

Intervention to restore blood flow. Common forms of revascularisation include coronary artery bypass graft (CABG) and percutaneous transluminal coronary angioplasty (PTCA), with or without the implantation of coronary prosthesis (stent, a tube used to keep blood vessels open to maintain blood flow).

Systolic blood pressure
This represents the pressure of the blood when the heart contracts. This is when the blood pressure is highest.

Run-in period
A period before randomisation that can be used to increase the efficiency of the trial e.g., by examining patients’ tolerance to the study medication or their compliance to taking their treatment.

These are studies nested within the main study, which provide an opportunity to investigate the study population to answer more than the original question driving the rationale for the main study.

A cardiovascular disease in which a blood vessel bringing oxygen and nutrients to the brain bursts or is clogged by a blood clot or some other particle. Deprived of oxygen, nerve cells in the brain cannot function and die, stopping the function of the parts of the body they control.

Transient Ischaemic Attacks (TIA)
A minor reversible form of stroke.

This website is intended for an international audience. Drug related information may refer to unlicensed products or uses which may not be approved in your own country and you should therefore consult your local prescribing information.
This site is published and updated by the EUROPA study investigators. Site last updated March 21st 2006
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