Abstract:
AIMS:To conduct a prospective, individual participant data (IPD) meta-analysis of randomised controlled trials comparing a polypill-based approach with usual care in high risk individuals. METHODS AND RESULTS:Three trials comparing polypill-based care with usual care in individuals with CVD or high calculated cardiovascular risk contributed IPD. Primary outcomes were self-reported adherence to combination therapy (anti-platelet, statin and ≥ two blood pressure (BP) lowering agents), and difference in mean systolic BP (SBP) and LDL-cholesterol at 12 months. Analyses used random effects models. Among 3140 patients from Australia, England, India, Ireland, New Zealand and The Netherlands (75% male, mean age 62 years), median follow-up was 15 months. At baseline, 84%, 87% and 61% respectively were taking a statin, anti-platelet agent and at least two BP lowering agents. At 12 months, compared to usual care, participants in the polypill arm had higher adherence to combination therapy (80% vs. 50%, RR 1.58; 95% CI, 1.32 to 1.90; p < 0.001), lower SBP (-2.5 mmHg; 95% CI, -4.5 to -0.4; p = 0.02) and lower LDL-cholesterol (-0.1 mmol/L; 95% CI, -0.2 to 0.0; p = 0.04). Baseline treatment levels were a major effect modifier for adherence and SBP (p-homog < 0.0001 and 0.02 respectively) with greatest improvements seen among those under-treated at baseline. CONCLUSIONS:Polypill therapy significantly improved adherence, SBP and LDL-cholesterol in high risk patients compared with usual care, especially among those who were under-treated at baseline.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Webster R,Patel A,Selak V,Billot L,Bots ML,Brown A,Bullen C,Cass A,Crengle S,Raina Elley C,Grobbee DE,Neal B,Peiris D,Poulter N,Prabhakaran D,Rafter N,Stanton A,Stepien S,Thom S,Usherwood T,Wadham A,Rodgers A,doi
10.1016/j.ijcard.2015.12.015subject
Has Abstractpub_date
2016-02-15 00:00:00pages
147-156eissn
0167-5273issn
1874-1754pii
S0167-5273(15)31008-1journal_volume
205pub_type
杂志文章abstract::A 42-year-old man was hospitalized for investigation of repeated episodes of ventricular fibrillation (Vf). Electrocardiogram (ECG) showed typical features of Brugada syndrome. Echocardiography, coronary angiography and endomyocardial biopsy specimen were normal. 123I-MIBG scintigraphy showed homogeneous reduction of ...
journal_title:International journal of cardiology
pub_type: 杂志文章
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journal_title:International journal of cardiology
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更新日期:2020-09-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
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journal_title:International journal of cardiology
pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:2013-04-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2010.02.005
更新日期:2011-06-02 00:00:00
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
pub_type: 信件
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更新日期:2010-08-06 00:00:00
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journal_title:International journal of cardiology
pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:2013-10-03 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(92)90022-u
更新日期:1992-03-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:2017-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ijcard.2011.05.002
更新日期:2012-12-15 00:00:00
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更新日期:2009-01-09 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,meta分析,评审
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更新日期:2016-09-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2007.11.098
更新日期:2009-03-20 00:00:00
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pub_type: 杂志文章
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更新日期:1997-10-31 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,评审
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journal_title:International journal of cardiology
pub_type: 信件
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更新日期:2009-08-21 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,评审
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更新日期:2017-06-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2017-04-01 00:00:00