Science

Polypill that reduces cardiovascular mortality by a third in patients treated after a heart attack

A combination of three drugs is effective in preventing cardiovascular problems after a heart attack, reducing mortality from cardiovascular causes by 33%.

This is the polypill developed by the National Center for Cardiovascular Research (CNIC) and the pharmaceutical company Ferrer, both entities in Spain. The polypill includes three medications (aspirin, an angiotensin-converting enzyme (ACE) inhibitor, and a statin).

The efficacy of the polypill has been confirmed in the SECURE study, coordinated by the CNIC.

“The SECURE results reveal, for the first time, that the polypill containing aspirin, atorvastatin, and ramipril achieves clinically relevant reductions in recurrent cardiovascular events in patients who have suffered a myocardial infarction,” underlines the principal investigator of the SECURE study, Dr. Dr. Valentín Fuster, general director of the CNIC, director of the Mount Sinai Heart and medical director of the Mount Sinai Hospital.

SECURE included 2,499 patients from 7 European countries (Spain, Italy, Germany, Czech Republic, France, Poland and Hungary) who had suffered a myocardial infarction who were randomly assigned to receive standard treatment or the CNIC polypill . The average age of the participants was 76 years and 31% were women. 77.9% had hypertension, 57.4% diabetes, and 51.3% a history of smoking.

Dr. Valentin Fuster. (Photo: CNIC)

The primary endpoint of the study included major cardiovascular events: death from cardiovascular causes, nonfatal myocardial infarction, stroke, or urgent revascularization. The data from the SECURE study, with a mean follow-up of patients of three years, are conclusive in terms of this objective. The study found a 24% decrease in the cumulative risk of these four events in patients who received the polypill compared to those who continued to take the treatment separately on a regular basis.

Especially relevant are the effects of the polypill on one of the most determining variables, the incidence of cardiovascular death, which decreased by 33%, from 71 patients in the usual treatment group to 48 in the polypill group.

In addition, patients in the polypill group had higher levels of adherence compared to those in the usual care group, thus confirming the findings of the FOCUS2 study, also funded by the EU.

“Adherence to treatment after acute myocardial infarction is essential for effective secondary prevention. The polypill, as it is a very simple strategy that combines three of the baseline treatments in this type of patient, has demonstrated its value since the increase in adherence means that patients are being better treated and, thanks to this, they have less risk of suffering cardiovascular events”, adds Dr. José María Castellano, scientific director of the HM Hospitales Research Foundation and first author of the study.

Dr. Fuster concludes: “The findings of the SECURE study suggest that the polypill could become an integral part of strategies to prevent cardiovascular events in patients who have suffered a heart attack. By simplifying treatment and improving adherence, this approach has the potential to reduce the risk of recurrent disease and cardiovascular death on a global scale.”

The findings of the SECURE study have been presented at the European Congress of Cardiology (ESC 2022). (Source: CNIC)

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