The polypill: an emerging treatment alternative for secondary prevention of cardiovascular disease

Hedner, Thomas; Kjeldsen, Sverre E.; Oparil, Suzanne

doi:10.3109/08037051.2016.1139324

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…The ‘healthy adherer’ phenomenon has been debunked in cardiology as survival benefit is actually associated with class‐specific medication adherence rather than overall healthy behaviour of compliant patients 17 . In the future, the concept of a secondary prevention polypill may play a role given all secondary prevention therapies, apart from ticagrelor, are now generic and relatively inexpensive 39 …”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of suboptimal secondary prevention pharmacotherapy after acute coronary syndromes

Yudi

Farouque

Andrianopoulos

et al. 2021

Internal Medicine Journal

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Background Optimal secondary prevention pharmacotherapy is the cornerstone of post‐acute coronary syndrome (ACS) management. The prognostic impact of not receiving five guideline‐recommended therapies is poorly described. Aim To ascertain the prognostic significance of suboptimal pharmacotherapy in ACS survivors. Methods Consecutive patients with ACS from the Melbourne Interventional Group registry who were alive at 30 days following their index percutaneous coronary intervention were included. Patients were divided into three categories based on the number of secondary prevention medications prescribed. The optimal medical therapy (OMT), near‐optimal medical therapy (NMT), suboptimal medical therapy (SMT) groups were prescribed 5, 4 and ≤ 3 medications, respectively. Primary endpoint was long‐term mortality. Cox‐proportional hazard modelling was undertaken to assess independent predictors of survival. Results Of the 9375 patients included, 5678 (60.6%) received OMT, 2903 (31.0%) received NMT and 794 (8.5%) received SMT. Patients receiving SMT were older, more likely to be female and had higher burden of comorbidities (renal impairment, congestive heart failure, diabetes, peripheral vascular disease; P < 0.01 for all). SMT was associated with higher long‐term mortality at 3.9 ± 2.2 years when compared to NMT and OMT (16.8% vs 10.5% vs 8.2%, P < 0.001). Compared to OMT, SMT was an independent predictor of long‐term mortality (hazard ratio, HR 1.62, 95% confidence interval, CI 1.30–2.02, P < 0.01) while NMT was associated with a clinically significant 14% mortality hazard (HR 1.14, 95% CI 0.97–1.34, P = 0.11). Conclusions There is a graded long‐term hazard associated with not receiving OMT after an ACS. Improvements in secondary prevention pharmacotherapy models of care are warranted to further decrease the long‐term mortality.

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Section: Discussionmentioning

confidence: 99%

Prognostic significance of suboptimal secondary prevention pharmacotherapy after acute coronary syndromes

Yudi

Farouque

Andrianopoulos

et al. 2021

Internal Medicine Journal

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Health Benefits of Anti-aging Drugs

Piskovatska

Strilbytska

Koliada

et al. 2019

Subcellular Biochemistry

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Achievement of treatment goals for secondary prevention of myocardial infarction or stroke in 29,325 patients with type 2 diabetes: a German/Austrian DPV-multicenter analysis

Bohn

Schöfl

Zimmer

et al. 2016

Cardiovasc Diabetol

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BackgroundTo analyze whether medical care is in accordance with guidelines for secondary prevention of myocardial infarction (MI), or stroke in patients with type 2 diabetes from Germany and Austria.Methods29,325 patients (≥20 years of age) with type 2 diabetes and MI, or stroke, documented between 2006 and 2015 were selected from the Diabetes-Patienten-Verlaufsdokumentation database. We analyzed medication, clinical characteristics, and lifestyle factors according to national secondary prevention guidelines in patients with MI, or stroke, separately.ResultsHbA1C <7.5 % was achieved in 64.9 % (MI), and in 61.1 % (stroke) of patients. LDL <100 mg/dl was documented in 56.2 % (MI), and in 42.2 % (stroke). Non-smoking was reported in 92.0 % (MI), and in 93.1 % (stroke), physical activity in 9.6 % (MI), and 5.5 % (stroke). Target values of blood pressure (<130/80 mmHg in MI, 120/70–140/90 in stroke) were reached in 67.0 % (MI), and in 89.9 % (stroke). Prescription prevalence of inhibitors of platelet aggregation (IPA) was 50.7 % (MI), and 31.7 % (stroke). 57.0 % (MI), and 40.1 % (stroke) used statins, 65.1 % (MI), and 65.8 % (stroke) used any type of antihypertensives, and ACE inhibitors were prescribed in 49.7 % (MI), and 41.3 % (stroke). A body mass index (BMI) <27 kg/m2 and the use of beta blockers were only recommended in subjects with MI. Of the patients with MI, 32.0 % had a BMI <27 kg/m2, and 59.5 % used beta blockers.ConclusionsAchievement of treatment goals in secondary prevention of MI, or stroke in subjects with type 2 diabetes needs improvement. Target goals were met more frequently in patients with MI compared to subjects with stroke. Especially the use of IPA was very low in patients with stroke. There remains great potential to reduce the risk of repeated macrovascular events and premature death, as well as to increase patients’ quality of life.

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The polypill: an emerging treatment alternative for secondary prevention of cardiovascular disease

Cited by 3 publications

References 26 publications

Prognostic significance of suboptimal secondary prevention pharmacotherapy after acute coronary syndromes

Prognostic significance of suboptimal secondary prevention pharmacotherapy after acute coronary syndromes

Health Benefits of Anti-aging Drugs

Achievement of treatment goals for secondary prevention of myocardial infarction or stroke in 29,325 patients with type 2 diabetes: a German/Austrian DPV-multicenter analysis

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