Practical Decision Algorithms for the Use of the Cardiovascular Polypill in Secondary Prevention in Europe
The main objective of cardiovascular disease (CVD) prevention is to reduce morbidity and mortality. Despite recommendations on evidence-based pharmacological treatment and lifestyle changes, the control of CV risk factors such as hypertension or dyslipidaemia is not optimal. The use of a CV polypill...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.663361/full |
| _version_ | 1818717409815560192 |
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| author | Lilian Grigorian-Shamagian Lilian Grigorian-Shamagian Klaus Edel María Asunción Esteve-Pastor Álvaro Aceña Claudia Silva Joana Delgado-Silva Georges Ntaios Eftychia Demerouti Carlos Brotons Carlos Brotons |
| author_facet | Lilian Grigorian-Shamagian Lilian Grigorian-Shamagian Klaus Edel María Asunción Esteve-Pastor Álvaro Aceña Claudia Silva Joana Delgado-Silva Georges Ntaios Eftychia Demerouti Carlos Brotons Carlos Brotons |
| author_sort | Lilian Grigorian-Shamagian |
| collection | DOAJ |
| description | The main objective of cardiovascular disease (CVD) prevention is to reduce morbidity and mortality. Despite recommendations on evidence-based pharmacological treatment and lifestyle changes, the control of CV risk factors such as hypertension or dyslipidaemia is not optimal. The use of a CV polypill, including guideline-recommended drugs, as a baseline therapy, may contribute to improving risk factors control either by improving the treatment adherence or by the synergistic effect of its components. The CNIC-Polypill is the first CV polypill approved in Europe as an effective strategy for secondary prevention, which contains acetylsalicylic acid, atorvastatin (in two optional doses), and ramipril (in three optional doses) in a single pill. The present practical clinical document aims to provide a guide for patient management after an acute coronary syndrome (ACS) or with chronic CVD (CCVD) with a strategy based on the CNIC-Polypill, also considering the need to add other therapies for a personalized treatment. The most suitable clinical scenarios for the CNIC-Polypill use are discussed: (a) in patients after an ACS at discharge, (b) in patients with CCVD (chronic coronary syndrome, stroke, or peripheral artery disease) with uncontrolled low-density lipoprotein cholesterol (LDL-c) and/or blood pressure levels and (c) in patients with CCVD with well-controlled risk factors to simplify treatment and reduce polypharmacy in the context of CCVD prevention. |
| first_indexed | 2024-12-17T19:34:42Z |
| format | Article |
| id | doaj.art-414fef5fb0bc46909dd9295b208c486a |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-17T19:34:42Z |
| publishDate | 2021-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-414fef5fb0bc46909dd9295b208c486a2022-12-21T21:35:10ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-08-01810.3389/fcvm.2021.663361663361Practical Decision Algorithms for the Use of the Cardiovascular Polypill in Secondary Prevention in EuropeLilian Grigorian-Shamagian0Lilian Grigorian-Shamagian1Klaus Edel2María Asunción Esteve-Pastor3Álvaro Aceña4Claudia Silva5Joana Delgado-Silva6Georges Ntaios7Eftychia Demerouti8Carlos Brotons9Carlos Brotons10Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón and Facultad de Medicina, Universidad Complutense de Madrid, Madrid, SpainCentro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, SpainCenter of Cardiovascular Diseases, Department of Cardiol. Rehabilitation, Rotenburg, GermanyDepartment of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, Murcia, SpainDepartment of Cardiology, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, SpainUSF Cruz de Celas, Coimbra, PortugalDepartment of Cardiology, Coimbra Hospital and University Centre, Coimbra, PortugalDepartment of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, GreeceOnassis Cardiac Surgery Center, Kallithea, Greece0Sardenya Primary Health Care Center, Barcelona, Spain1Biomedical Research Institute Sant Pau, Barcelona, SpainThe main objective of cardiovascular disease (CVD) prevention is to reduce morbidity and mortality. Despite recommendations on evidence-based pharmacological treatment and lifestyle changes, the control of CV risk factors such as hypertension or dyslipidaemia is not optimal. The use of a CV polypill, including guideline-recommended drugs, as a baseline therapy, may contribute to improving risk factors control either by improving the treatment adherence or by the synergistic effect of its components. The CNIC-Polypill is the first CV polypill approved in Europe as an effective strategy for secondary prevention, which contains acetylsalicylic acid, atorvastatin (in two optional doses), and ramipril (in three optional doses) in a single pill. The present practical clinical document aims to provide a guide for patient management after an acute coronary syndrome (ACS) or with chronic CVD (CCVD) with a strategy based on the CNIC-Polypill, also considering the need to add other therapies for a personalized treatment. The most suitable clinical scenarios for the CNIC-Polypill use are discussed: (a) in patients after an ACS at discharge, (b) in patients with CCVD (chronic coronary syndrome, stroke, or peripheral artery disease) with uncontrolled low-density lipoprotein cholesterol (LDL-c) and/or blood pressure levels and (c) in patients with CCVD with well-controlled risk factors to simplify treatment and reduce polypharmacy in the context of CCVD prevention.https://www.frontiersin.org/articles/10.3389/fcvm.2021.663361/fullpolypillfixed-dose combinationsecondary preventioncardiovascular diseasecerebrovascular disease |
| spellingShingle | Lilian Grigorian-Shamagian Lilian Grigorian-Shamagian Klaus Edel María Asunción Esteve-Pastor Álvaro Aceña Claudia Silva Joana Delgado-Silva Georges Ntaios Eftychia Demerouti Carlos Brotons Carlos Brotons Practical Decision Algorithms for the Use of the Cardiovascular Polypill in Secondary Prevention in Europe Frontiers in Cardiovascular Medicine polypill fixed-dose combination secondary prevention cardiovascular disease cerebrovascular disease |
| title | Practical Decision Algorithms for the Use of the Cardiovascular Polypill in Secondary Prevention in Europe |
| title_full | Practical Decision Algorithms for the Use of the Cardiovascular Polypill in Secondary Prevention in Europe |
| title_fullStr | Practical Decision Algorithms for the Use of the Cardiovascular Polypill in Secondary Prevention in Europe |
| title_full_unstemmed | Practical Decision Algorithms for the Use of the Cardiovascular Polypill in Secondary Prevention in Europe |
| title_short | Practical Decision Algorithms for the Use of the Cardiovascular Polypill in Secondary Prevention in Europe |
| title_sort | practical decision algorithms for the use of the cardiovascular polypill in secondary prevention in europe |
| topic | polypill fixed-dose combination secondary prevention cardiovascular disease cerebrovascular disease |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.663361/full |
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