Polypill Cuts Cardiovascular Event Risk in Seniors With Recent MI

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Polypill comprising aspirin, ramipril, atorvastatin effective for secondary prevention of cardiovascular disease in older adults

TUESDAY, Aug. 30, 2022 (HealthDay News) — The risk for major adverse cardiovascular events is reduced among patients within six months of previous myocardial infarction who receive treatment with a polypill compared with usual care, according to a study published online Aug. 26 in the New England Journal of Medicine to coincide with the European Society of Cardiology Congress 2022, held from Aug. 26 to 29 in Barcelona, Spain.

Jose M. Castellano, M.D., Ph.D., from Centro Nacional de Investigaciones Cardiovasculares in Madrid, and colleagues conducted a phase 3 randomized trial involving patients with myocardial infarction within the previous six months who were randomly assigned to either a polypill-based strategy, consisting of aspirin, ramipril, and atorvastatin, or usual care. A total of 2,499 patients were randomly assigned and followed for a median of 36 months.

The researchers found that a primary outcome event (cardiovascular death, nonfatal type 1 myocardial infarction, nonfatal ischemic stroke, or urgent revascularization) occurred in 9.5 percent of 1,237 patients in the polypill group and in 12.7 percent of 1,229 patients in the usual-care group (hazard ratio, 0.76). A key secondary outcome event (cardiovascular death, nonfatal type 1 myocardial infarction, or nonfatal ischemic stroke) occurred in 8.2 and 11.7 percent of patients in the polypill and usual-care groups, respectively (hazard ratio, 0.70). Patient-reported medication adherence was higher in the polypill group.

“By simplifying treatment complexity and improving availability, the use of a polypill is a widely applicable strategy to improve accessibility and adherence to treatment, thus decreasing the risk of recurrent disease and cardiovascular death,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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