A Polypill Strategy for the Secondary Prevention of Cardiovascular Disease

Fixed-dose combination pills containing aspirin, a statin, and an ACE inhibitor improved outcomes in older patients with recent myocardial infarction.

A “polypill” — a single pill combining key medications associated with improved cardiovascular outcomes — has been shown in multiple randomized trials to reduce cardiovascular events in primary prevention (NEJM JW Gen Med Oct 2021 and Lancet 2021; 398:1133; NEJM JW Cardiol Jan 2021 and N Engl J Med 2021; 384:216; NEJM JW Gen Med Oct 2019 and Lancet 2019; 394:672). A gap in knowledge is the benefit of a polypill strategy in older patients and in secondary prevention.

In this phase 3, open-label, randomized, controlled trial (NCT02596126), 2499 patients aged ≥75 (or aged ≥65 years with ≥1 cardiovascular risk factor) who had a myocardial infarction (MI) in the prior 6 months were randomized to a polypill-based strategy consisting of aspirin (10…

Reviewing Author

Karol E. Watson, MD, PhD, FACC

Disclosures

Consultant/Advisory BoardBoehringer Ingelheim; Amgen; Novartis; Lilly; Amarin

Speaker’s BureauBoehringer Ingelheim

Grant/Research SupportNIH

Editorial BoardsCirculation (Associate Editor)