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CHIESI HELLAS


SANOFI

A “Poly-Portfolio” for Secondary Prevention: A Strategy to Reduce Subsequent Events By Up to 97% Over Five Years

Jennifer G. Robinson, MD, MPH, and Nidhi Maheshwari, MBBS

A "polypill" for the primary prevention of cardiovascular disease has been proposed. We estimated the projected benefit of a secondary prevention "poly-portfolio" strategy, including pharmacologic and lifestyle approaches for those with coronary heart disease (CHD) or stroke. Based on recent clinical trial results and clinical guidelines, combinations of a high-dose statin, low to standard doses of antihypertensive therapy, aspirin, omega-3 fish oil, cardiac rehabilitation, and diet were evaluated.

Patients with CHD, post-myocardial infarction (MI), or stroke were projected to experience 84%, 91%, and 77% reductions, respectively, in CHD events from a pharmacologic approach. Numbers of those needed to treat (NNT) for 5 years were 9 to 11 to prevent 1 CHD event, and 21 to prevent 1 stroke. Post-MI patients were projected to experience a 93% reduction in the risk of CHD death (NNT 16) from a pharmacologic approach and a 97% reduction in the risk of CHD death (NNT 15) with the addition of lifestyle changes.

A secondary prevention polyportfolio holds great promise for reducing the burden of cardiovascular disease in the highest risk patients. _2005 by Excerpta Medica Inc.  

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