1. Baseline characteristics

2. Patient flow Completed 6 107 Completed 6 108 Perindopril 6 110 Placebo 6 108 Randomised 12 218 Not randomised 1 437 Registered 13 655

3. 424 centres : 12 218 patients 102 176141130 57 1251 2176 115 94 300 399 285 511 890 17 22 2068 1772 277 134 209 65 197 830

4. Not randomised Overall: 1 437 of 13 655 pts 10.5 IntoleranceHypotension Creatinine/Potassium rise Poor compliance Major clinical event Non medical reasons Unspecified2.42.11.10.60.50.53.3%

5. Perindopril (mean  SD) Placebo Age (yrs) 60  9 Male (%) 8685 Weight (kg) 81  12 80  12 HR (bpm) 68  10 SBP (mmHg) 137  16 137  15 DBP (mmHg) 82  8 Baseline characteristics

6. Perindopril(%)Placebo (%) (%) Myocardial infarction 64.964.7 Revascularisation54.755.2 Stroke / TIA 3.43.3 Heart failure 1.31.2 Peripheral vascular disease 7.17.4 Medical history

7. Perindopril(%)Placebo (%) (%) Hypertension27.027.2 Diabetes mellitus 11.812.8 Hypercholesterolaemia63.363.3 Current smoker 15.415.1 Risk factors

8. Perindopril(%)Placebo(%) Platelet inhibitors 91.992.7  -blockers 62.061.3 Lipid lowering drugs 57.857.3 Nitrates42.843.0 Ca-blockers31.731.0 Diuretics9.19.4 Oral anticoagulants 4.44.2 Baseline medication

9. Results

10. Primary endpoint % CV death, MI or cardiac arrest Placebo annual event rate: 2.4% Perindopril Placebo p = 0.0003 RRR: 20% Years 0 2 4 6 8 10 12140 1 2345

11. Primary and first secondary endpoint 0.51.02.0 20 14 22 46 14 RRR (%) Perindopril better Placebo better CV mortality, MI, CA CV mortality Non fatal MI Cardiac arrest Total mortality, MI, UAP,CA

12. Sub-groups analysis RRR (%) 0.51.02.0 Perindopril better Placebo better Previous MI No previous MI 22.4 12.1 Age  56 yrs Age 57 - 65 Age > 65 yrs 27.3 14.3 18.2 Male Female 19.3 22.0

13. Sub-groups analysis 0.51.0 2.0 Hypertension RRR (%) Perindopril better Placebo better No hypertension Diabetes mellitus No diabetes mellitus Stroke/TIA No stroke/TIA 18.6 19.9 18.9 19.0 15.8 19.9

14. 92% patients on platelet inhibitors Sub-groups analysis RRR (%) Lipid lowering drug Perindopril better Placebo better 0.51.02.0 No lipid lowering drug  -blockers No  -blockers Calcium blockers No calcium blockers 16.3 22.3 26.4 7.0 15.8 22.2

15. Secondary endpoints Fatal & non fatal MI, unstable angina 0.51.02.0 Perindopril better Placebo better Total mortality, MI, UAP,CA CV mortality & MI CV mortality, MI & stroke CV mortality, MI, revascularisation CV mortality, MI, unstable angina Non fatal and fatal MI Total mortality CV mortality Unstable angina Cardiac arrest Stroke Revascularisation Heart failure RRR (%) 14.0 19.3 17.4 11.3 15.5 16.5 23.9 11.0 13.9 7.1 45.6 4.3 4.2 39.2

16. Fatal and non fatal MI Perindopril Placebo 0 2 4 6 810 012345Years(%) p < 0.001 RRR: 24%

17. Hospitalisation for heart failure Perindopril Placebo 501234Years p = 0.002 RRR: 39% 0.0 0.5 1.0 1.5 2.0(%)

18. -1/2036121824303642485460 Months 70 80 90 100 110 120 130 140mmHg Blood pressure  SBP: 5 mmHg  DBP: 2 mmHg Perindopril 8mg Placebo

19. Adherence to treatment 061218243036 Months 0 20 40 60 80 100 120 (%)Placebo Perindopril 8mg

20. Withdrawal from treatment Perindopril%Placebo% Cough2.70.5 Hypotension1.00.3 Kidney failure 0.30.3 Intolerance2.41.3 Study end-point 6.27.5 Hypertension0.40.8 Refuse to continue 4.34.2 Other reason 5.75.8