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Ros-Castelló, Victoria; Natera-Villalba, Elena; Gómez-López, Ana; Sánchez-Sánchez, Arantxa; Chico-García, Juan Luis; García-Madrona, Sebastian; Vera-Lechuga, Rocio; Matute-Lozano, Consuelo; de Felipe Mimbrera, Alicia; Cruz-Culebras, Antonio; Alonso-Canovas, Araceli; Masjuan, Jaime

Use of the Cardiovascular Polypill in Secondary Prevention of Cerebrovascular Disease: A Real-Life Tertiary Hospital Cohort Study of 104 Patients

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  • Media type: E-Article
  • Title: Use of the Cardiovascular Polypill in Secondary Prevention of Cerebrovascular Disease: A Real-Life Tertiary Hospital Cohort Study of 104 Patients
  • Contributor: Ros-Castelló, Victoria; Natera-Villalba, Elena; Gómez-López, Ana; Sánchez-Sánchez, Arantxa; Chico-García, Juan Luis; García-Madrona, Sebastian; Vera-Lechuga, Rocio; Matute-Lozano, Consuelo; de Felipe Mimbrera, Alicia; Cruz-Culebras, Antonio; Alonso-Canovas, Araceli; Masjuan, Jaime
  • imprint: S. Karger AG, 2020
  • Published in: Cerebrovascular Diseases Extra
  • Language: English
  • DOI: 10.1159/000511064
  • ISSN: 1664-5456
  • Keywords: Cardiology and Cardiovascular Medicine ; Neurology (clinical) ; Neurology
  • Origination:
  • Footnote:
  • Description: <jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; The use of the cardiovascular polypill, a fixed-dose combination treatment, is conceived to improve adherence. However, randomized controlled trials (RCTs) may overestimate it. Studies focusing on cerebrovascular disease and real-life efficacy compared with conventional treatment are lacking. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; This is a retrospective, hospital-based cohort study of acute ischaemic stroke patients who were prescribed a polypill (aspirin 100 mg, atorvastatin 20/40 mg, ramipril 2.5/5/10 mg) versus conventional treatment (aspirin 100 mg and other blood pressure/lipid-lowering agents) in secondary prevention (2017–2018). Clinical records were reviewed 90 days after discharge for stroke recurrence, vascular risk factor control, and safety. Adherence was assessed using the adapted Morisky-Green scale. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; A total of 104 patients were included (61% male; mean age 69.7 ± 13.9 years); 54 were treated with the polypill and 50 with conventional treatment. No baseline differences in clinical or demographic variables were detected. No recurrences were registered in the polypill group, compared to 1 recurrence in the conventional treatment group. A significant reduction of systolic blood pressure (SBP) was achieved in the polypill group (12.1 mm Hg) compared to the conventional treatment group (6.8 mm Hg) (&lt;i&gt;p&lt;/i&gt; = 0.002). No significant differences were detected regarding the goal of LDL cholesterol ≤70 mg/dL (41 vs. 44%). The adverse events were mild and their frequency was similar in the two groups (9 vs. 2%, ns). Adherence was similarly good in the two groups (93 vs. 88%, ns). Polypill group adherence was similar to that reported in a previous meta-analysis of RCTs (93 vs. 84%, ns). &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; In our experience, the cardiovascular polypill achieved a higher reduction in SBP levels and was well tolerated. Adherence was similar to that found in the previous literature, which is remarkable given the real-life setting of our study. </jats:p>
  • Access State: Open Access