The CNIC-polypill (acetylsalicylic acid, atorvastatin, and ramipril), an effective and cost-saving secondary prevention strategy compared with other therapeutic options in patients with ischaemic heart disease
Year: 2024
Type: article
Abstract: Aims The retrospective NEPTUNO study evaluated the effectiveness of the Centro Nacional de Investigaciones Cardiovasculares (CNIC)-polypill (including acetylsalicylic acid, ramipril, and atorvastatin) vs. other therapeutic approaches in secondary prevention for cardiovascular (CV) disease. In this substudy, the focus was on the subgroup of patients with ischaemic heart disease (IHD). Methods and results Patients on four strategies: CNIC-polypill, its monocomponents as loose medications, equipotent medications, and other therapies. The primary endpoint was the incidence of recurrent major adverse CV events (MACEs) after 2 years. After matching, 1080 patients were included in each cohort. The CNIC-polypill cohort had a significantly lower incidence of recurrent MACE compared with monocomponents, equipotent drugs, and other therapies cohorts (16.1 vs. 24, 24.4, and 24.3%, respectively; P < 0.001). The hazard ratios (HRs) for recurrent MACE were higher in monocomponents (HR = 1.12; P = 0.042), equipotent drugs (HR = 1.14; P = 0.031), and other therapies cohorts (HR = 1.17; P = 0.016) compared with the CNIC-polypill, with a number needed to treat of 12 patients to prevent a MACE. The CNIC-polypill demonstrated a greater reduction in LDL cholesterol (LDL-c; −56.1 vs. −43.6, −33.3, and −33.2% in the monocomponents, equipotent drugs, and other therapies, respectively; P < 0.001) and systolic blood pressure (−13.7 vs. −11.5, −10.6, and −9.1% in the CNIC-polypill, monocomponents, equipotent drugs, and other therapies, respectively; P < 0.001) compared with other cohorts. The CNIC-polypill intervention was less costly and more effective than any other therapeutic option, with €2317–€2407 cost savings per event prevented. Conclusion In IHD, the CNIC-polypill exemplifies a guideline-recommended secondary prevention treatment linked to better outcomes and cost saving compared with other therapeutic options.
Source: European Heart Journal Open
Authors: Regina Dalmau, Alberto Cordero, Luís Masana, Emilio Ruiz, Antoni Sicras-Mainar, José R González-Juanatey
Institutions: Hospital Universitario La Paz, Hospital La Paz Institute for Health Research, Hospital Universitari Sant Joan D'Alacant, Centro de Investigación en Red en Enfermedades Cardiovasculares, Centro de Investigación Biomédica en Red, Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas, Institut de Recerca Biomèdica Catalunya Sud, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Ferrer Grupo (Spain), Complejo Hospitalario Universitario de Santiago, Instituto de Investigación Sanitaria de Santiago
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,688
Funders: Amgen, Eli Lilly and Company, AstraZeneca, Joint Programming Initiative A healthy diet for a healthy life, Amarin Corporation, Amryt Pharma, National Institute for Health and Care Research, Guy's and St Thomas' Charity, European Commission, King's Health Partners, Generalitat de Catalunya, Daiichi-Sankyo, Novo Nordisk, Tommy's, Servier, World Heart Federation, Grupo Ferrer Internacional, S.A, Medical Research Council, Programme Grants for Applied Research, Agencia Estatal de Investigación, NextGenerationEU
Awards: G1093531541, G1563105402, G1652070670, G2473961061, G2566874064, G2905090494, G3005324705, Statistical modelling to characterise the dietary determinants of health outcomes in mothers and their children., ERA-Net on INtesTInal MICrobiomics, diet and health, implementing JPI HDHL objectives, G4653281258, G5605571342, G6054710752, G6470444756, G8537530744, Long-term effects of early nutrition on later health
OpenAlex ID: W4393411811