Polypill/Aspirin Combination Reduces Cardiovascular Events in Participants with Increased CV Risk .
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Polypill with or without Aspirin in Persons without Cardiovascular Disease
N Engl J Med. 2020 Nov 13.Five thousand, seven hundred and thirteen patients with elevated cardiovascular risk were randomized to receive a polypill (containing lipid and blood pressuring lowering agents), aspirin, polypill and aspirin, or placebo for the prevention of cardiovascular events. The primary outcome of interest for the polypill and polypill plus aspirin groups was a composite of death from major cardiovascular events, including death from cardiovascular causes, stroke, myocardial infarction, heart failure, resuscitated cardiac arrest, and arterial revascularization. For the aspirin only group, the primary outcome of interest was a composite outcome of death from cardiovascular causes, myocardial infarction or stroke. Secondary outcomes of interest included major cardiovascular events and the incidence of angina with evidence of ischemia. The mean follow up time was 4.6 years. Study results demonstrated lower rates of death from cardiovascular events in the polypill group, polypill plus aspirin group, and aspirin only group compared to placebo. Moreover, the use of the polypill/aspirin combo was found to led to a 31% lower relative risk of cardiovascular events compared to placebo. Additionally, low-density lipoprotein (LDL) cholesterol levels, blood pressure, and heart rate were lower in the polypill plus aspirin and polypill only groups compared to placebo.
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