Polypills for Primary Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis
PurposeTo evaluate the effect of polypills on the primary prevention of cardiovascular (CV) events using data from clinical trials.MethodsWe searched PubMed, Web of Science, EBSCO, and SCOPUS throughout May 2021. Two authors independently screened articles for the fulfillment of inclusion criteria....
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.880054/full |
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| author | Omneya A. Kandil Karam R. Motawea Merna M. Aboelenein Jaffer Shah |
| author_facet | Omneya A. Kandil Karam R. Motawea Merna M. Aboelenein Jaffer Shah |
| author_sort | Omneya A. Kandil |
| collection | DOAJ |
| description | PurposeTo evaluate the effect of polypills on the primary prevention of cardiovascular (CV) events using data from clinical trials.MethodsWe searched PubMed, Web of Science, EBSCO, and SCOPUS throughout May 2021. Two authors independently screened articles for the fulfillment of inclusion criteria. The RevMan software (version 5.4) was used to calculate the pooled risk ratios (RRs) and mean differences (MDs), along with their associated confidence intervals (95% CI).ResultsEight trials with a total of 20653 patients were included. There was a significant reduction in the total number of fatal and non-fatal CV events among the polypill group [RR (95% CI) = 0.71 (0.63, 0.80); P-value < 0.001]. This reduction was observed in both the intermediate-risk [RR (95% CI) = 0.76 (0.65, 0.89); P-value < 0.001] and high-risk [RR (95% CI) = 0.63 (0.52, 0.76); P-value < 0.001] groups of patients. Subgroup analysis was performed based on the follow-up duration of each study, and benefits were only evident in the five-year follow-up duration group [RR (95% CI) = 0.70 (0.62, 0.79); P-value < 0.001]. Benefits were absent in the one-year-or-less interval group [RR (95% CI) = 0.77 (0.47, 1.29); P-value = 0.330]. Additionally, there was a significant reduction in the 10-year predicted cardiovascular risk in the polypill group [MD (95% CI) = −3.74 (−5.96, −1.51); P-value < 0.001], as compared to controls.ConclusionA polypill regimen decreases the incidence of fatal and non-fatal CV events in patients with intermediate- and high- cardiovascular risk, and therefore may be an effective treatment for these patients. |
| first_indexed | 2024-12-10T13:17:38Z |
| format | Article |
| id | doaj.art-9ced70ab912649279e3feee06c9f7063 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-10T13:17:38Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-9ced70ab912649279e3feee06c9f70632022-12-22T01:47:28ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-04-01910.3389/fcvm.2022.880054880054Polypills for Primary Prevention of Cardiovascular Disease: A Systematic Review and Meta-AnalysisOmneya A. Kandil0Karam R. Motawea1Merna M. Aboelenein2Jaffer Shah3Faculty of Medicine, Alexandria University, Alexandria, EgyptFaculty of Medicine, Alexandria University, Alexandria, EgyptFaculty of Medicine, Alexandria University, Alexandria, EgyptMedical Research Center, Kateb University, Kabul, AfghanistanPurposeTo evaluate the effect of polypills on the primary prevention of cardiovascular (CV) events using data from clinical trials.MethodsWe searched PubMed, Web of Science, EBSCO, and SCOPUS throughout May 2021. Two authors independently screened articles for the fulfillment of inclusion criteria. The RevMan software (version 5.4) was used to calculate the pooled risk ratios (RRs) and mean differences (MDs), along with their associated confidence intervals (95% CI).ResultsEight trials with a total of 20653 patients were included. There was a significant reduction in the total number of fatal and non-fatal CV events among the polypill group [RR (95% CI) = 0.71 (0.63, 0.80); P-value < 0.001]. This reduction was observed in both the intermediate-risk [RR (95% CI) = 0.76 (0.65, 0.89); P-value < 0.001] and high-risk [RR (95% CI) = 0.63 (0.52, 0.76); P-value < 0.001] groups of patients. Subgroup analysis was performed based on the follow-up duration of each study, and benefits were only evident in the five-year follow-up duration group [RR (95% CI) = 0.70 (0.62, 0.79); P-value < 0.001]. Benefits were absent in the one-year-or-less interval group [RR (95% CI) = 0.77 (0.47, 1.29); P-value = 0.330]. Additionally, there was a significant reduction in the 10-year predicted cardiovascular risk in the polypill group [MD (95% CI) = −3.74 (−5.96, −1.51); P-value < 0.001], as compared to controls.ConclusionA polypill regimen decreases the incidence of fatal and non-fatal CV events in patients with intermediate- and high- cardiovascular risk, and therefore may be an effective treatment for these patients.https://www.frontiersin.org/articles/10.3389/fcvm.2022.880054/fullprimary preventioncardiovascular eventsantihypertensivespolypilllipid-lowering |
| spellingShingle | Omneya A. Kandil Karam R. Motawea Merna M. Aboelenein Jaffer Shah Polypills for Primary Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis Frontiers in Cardiovascular Medicine primary prevention cardiovascular events antihypertensives polypill lipid-lowering |
| title | Polypills for Primary Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis |
| title_full | Polypills for Primary Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis |
| title_fullStr | Polypills for Primary Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Polypills for Primary Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis |
| title_short | Polypills for Primary Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis |
| title_sort | polypills for primary prevention of cardiovascular disease a systematic review and meta analysis |
| topic | primary prevention cardiovascular events antihypertensives polypill lipid-lowering |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.880054/full |
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