Polypill May Reduce Odds of Future Heart Attacks

Heart attack patients who are prescribed a polypill instead of multiple separate pills may improve their chances of preventing further heart attacks, according to a new study.

“The idea of using a polypill for CVD [cardiovascular disease] prevention has gained increasing momentum because it could increase adherence and therefore contain the progression of CVD. A polypill could simplify healthcare delivery, improve cost-effectiveness, support the comprehensive prescription of evidence-based cardioprotective drugs, and reach underdeveloped regions of the world,” said Valentin Fuster, FESC, the study’s presenter and director of Mount Sinai Heart Hospital.
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In the Fixed-dose Combination Drug for Secondary Cardiovascular Prevention (FOCUS) study, researchers studied the use of a polypill.

Phase 1 (FOCUS 1) included 2118 patients with a history of myocardial infraction (MI) to study adherence; researchers reported an average baseline adherence of 45.5%. Researchers noted that nonadherence was independently associated with younger age (under 50 years), scoring high on the depression scale, and complex treatments. Adherence correlated with health insurance coverage and social support.

In phase 2 (FOCUS 2), researchers investigated adherence to secondary prevention mediation and tested a polypill. In the study, 695 patients were followed for 9 months and randomized to either receive a polypill or 3 separate drugs.     

“FOCUS 2 has shown that, compared with the 3 drugs given separately, the use of a polypill strategy significantly increases self-reported and directly measured medication adherence for secondary prevention following an acute MI,” said Fuster.

FOCUS 2 is ongoing and will continue to assess whether differences between the 2 treatments in blood pressure, blood cholesterol, safety, and costs.  

The study was presented at the European Society of Cardiology (ESC) 2014 Congress in Barcelona, Spain on September 2, 2014.

-Michelle Canales

References:

Fuster VF, Castellan JM, Sanz G. Clinical trial update hot line: infraction, interventions and outcome.European Society of Cardiology Congress Report. September 2, 2014. www.escardio.org/congresses/esc-2014/congress-reports/Pages/712-5-CTUpdate1-FOCUS.aspx#.VAntpl4irwI. Accessed September 6, 2014.

European Society of Cardiology. FOCUS-Polypill increases adherence to post MI treatment. September 1, 2014. www.escardio.org/about/press/press-releases/esc14-barcelona/Pages/clinical-trial-update-focus.aspx. Accessed September 6, 2014.