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Meta-Analysis on the Clinical Outcomes With Polypills for Cardiovascular Disease Prevention.
Sedhom, Ramy; Hamed, Mohamed; Tan, Weiyi; Mansoor, Hend; Stoletniy, Liset; Mamas, Mamas; Abramov, Dmitry; Elgendy, Islam Y; Elbadawi, Ayman.
Afiliación
  • Sedhom R; Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California.
  • Hamed M; Department of Internal Medicine, Florida Atlantic University, Boca Raton, Florida.
  • Tan W; Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas.
  • Mansoor H; Department of Pharmacy, Practice and Science, College of Pharmacy and.
  • Stoletniy L; Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California.
  • Mamas M; Keele Cardiovascular Research Group, Center for Prognosis Research, Keele University, Keele, United Kingdom; Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom.
  • Abramov D; Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California.
  • Elgendy IY; Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, Kentucky.
  • Elbadawi A; Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: aymangalal24@hotmail.com.
Am J Cardiol ; 201: 211-218, 2023 08 15.
Article en En | MEDLINE | ID: mdl-37385176
Randomized controlled trials (RCTs) examining the outcomes of "polypill" therapy in cardiovascular disease prevention have yielded mixed results. We performed an electronic search through January 2023 for RCTs that examined the use of polypills for cardiovascular disease primary or secondary prevention. The primary outcome was the incidence of major adverse cardiac and cerebrovascular events (MACCEs). The final analysis included 11 RCTs with 25,389 patients; 12,791 patients were in the polypill arm, and 12,598 patients were in the control arm. The follow-up period ranged from 1 to 5.6 years. Polypill therapy was associated with a lower risk of MACCE (5.8% vs 7.7%; risk ratio [RR] 0.78, 95% confidence interval [CI] 0.67 to 0.91). The reduction of MACCE risk was consistent in both primary and secondary prevention. Polypill therapy was associated with a lower incidence of cardiovascular mortality (2.1% vs 3%; RR 0.69, 95% CI 0.55 to 0.87), myocardial infarction (2.3% vs 3.2%; RR 0.72, 95% CI 0.61 to 0.84) and stroke (0.9% vs 1.6%; RR 0.62, 95% CI 0.42 to 0.90). Polypill therapy was associated with a higher degree of adherence. There was no difference between both groups in the incidence of serious adverse events (16.1% vs 15.9%; RR 1.12, 95% CI 0.93 to 1.36). In conclusion, we found that a polypill strategy was associated with a lower incidence of cardiac events and higher adherence, without an increased incidence of adverse events. This benefit was consistent for both primary and secondary prevention.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Accidente Cerebrovascular / Infarto del Miocardio Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: En Revista: Am J Cardiol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Accidente Cerebrovascular / Infarto del Miocardio Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: En Revista: Am J Cardiol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos