European Primary Care Cardiovascular Society

Polypill reduces risk of cardiovascular outcomes in primary prevention

Fixed-dose combination therapies with and without aspirin for primary prevention of cardiovascular disease: an individual participant data meta-analysis

Literature - Joseph P, Roshandel G, Gaoet P et al. - Lancet. 2021 Aug 27;S0140-6736(21)01827-4. doi: 10.1016/S0140-6736(21)01827-4.

Introduction and methods

This individual participant data meta-analysis of three large RCTs assessed whether fixed-dose combination treatment strategies in primary prevention reduced CVD risk compared with a control strategy.

Data from in total 18 162 participants with no known vascular disease from TIPS-3, HOPE-3 and PolyIran were included in this analysis [1-3]. These trials tested a fixed-dose combination strategy consisting of at least two blood pressure lowering agents plus a statin, with or without aspirin, versus placebo or usual care in primary prevention of CVD. The primary composite outcome of this meta-analysis was time to first occurrence of CV death, MI, stroke, or arterial revascularization. Median follow-up was 5 years (IQR 4.8-5.6).

Main results

Conclusion

This individual participant data meta-analysis of three large RCTs showed that a fixed-dose combination strategy consisting of at least two blood pressure lowering agents plus a statin, with or without aspirin, reduced the risk of CV outcomes in participants without known vascular disease in primary prevention. The largest risk reductions were found for fixed-dose combinations containing aspirin compared to control.

References

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