Number of drugs used in secondary cardiovascular prevention and late survival in the population of Valencia Community, Spain

Redón, Josep; Uso, Ruth; Trillo, J.L.; Lopez, Cristina; Morales‐Olivas, Francisco J.; Navarro, Jorge; Sanchís, Juan; Gil, Vicente; Orozco‐Beltrán, Domingo

doi:10.1016/j.ijcard.2019.05.071

Cited by 8 publications

(8 citation statements)

References 31 publications

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“…In agreement with other studies, 22,34 we found that adherent patients to only 2 or 1 drugs had significant higher risk to composite endpoint compared with adherents to combinations of 4–3 drugs. However, splitting the composite endpoint in all‐cause mortality and MACE, we found that these differences between adherents to 4–3 drugs versus adherents to 2 and 1 drugs disappeared, and were not statistically significant for MACE subgroup.…”

Section: Discussionsupporting

confidence: 93%

“…Nearly half of patients were prescribed the four drugs recommended 11‐13 and 81% of them were adherent. The use of recommended drugs in our study population is in concordance with similar previous observational studies, 18,33 but was higher than other studies 10,20,22,34,35 …”

Section: Discussionsupporting

confidence: 92%

“…Patients with high adherence (PDC ≥80% or MPR ≥80%) to all drug classes had a significantly reduced risk for all‐cause mortality and MACE 7,20 . Other study found a lower mortality risk in patients receiving antiplatelets, statins and ACEI than those receiving less than 3 drugs, but the medication adherence was not assessed 22 …”

Section: Introductionmentioning

confidence: 96%

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Impact of adherence to drugs for secondary prevention on mortality and cardiovascular morbidity: A population‐based cohort study. IMPACT study

Sotorra-Figuerola

Ouchi

Giner-Soriano

et al. 2021

Pharmacoepidemiology and Drug

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Purpose Adherence to pharmacological therapy for secondary prevention after an acute coronary syndrome (ACS) reduces the risk of new cardiovascular events. However, several studies showed poor adherence. Our study aim was to assess the risk of a composite endpoint of major cardiovascular events (MACE) and all‐cause mortality according to the adherence to these drugs in patients after an ACS in a primary health care cohort. Methods Population‐based observational cohort study of patients with a first episode of ACS during 2009–2016. Data source: Information System for Research in Primary Care (SIDIAP) database. Drug adherence was evaluated through proportion of days covered (PDC). Results We included 7152 patients and 5692 (79.6%) were adherent (PDC ≥ 75%) to the study drugs during the first year after the event. Adherents to any combination showed a significant reduction of the composite endpoint risk (HR 0.80 [0.73–0.88]), and a significant lower probability of the composite endpoint than nonadherents for all drugs, except beta‐blockers. Adherents to 2 (HR 1.2; 95% CI 1.0–1.3) and 1 drug (HR 1.5; 95% CI 1.2–1.8) had higher composite endpoint risk compared to adherents to 4–3 drugs. Conclusion Adherence to any combination of recommended drugs reduced the composite endpoint risk, regardless the number of drugs prescribed. Adherence to a combination of 4–3 drugs was significantly associated with a reduced mortality risk compared with adherents to 2 or 1, but it was not significant for MACE.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

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Impact of adherence to drugs for secondary prevention on mortality and cardiovascular morbidity: A population‐based cohort study. IMPACT study

Sotorra-Figuerola

Ouchi

Giner-Soriano

et al. 2021

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

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“…On the other hand, Redón et al analyzed the secondary prevention therapies administered during the first year after the hospital admission (due to stroke, myocardial infarction, or coronary revascularization) between 01/01/2011 and 31/12/2013, of 92,432 patients in the Valencian Community ( 33 ). Nevertheless, our study will provide more updated information about the management of these patients, using a database representative of the Spanish population ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

Treatment patterns and use of healthcare resources of patients with atherosclerotic cardiovascular disease and hypercholesterolemia and patients with familial hypercholesterolemia in Spain: Protocol of the Reality study

Barrios

Ruiz

Cerezo

et al. 2022

Front. Cardiovasc. Med.

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BackgroundAtherosclerotic cardiovascular diseases (ASCVD) and dyslipidemia are associated to a higher risk of cardiovascular events, mortality, use of healthcare resources and costs. In Spain, the evidence about the administration of lipid-lowering treatments in clinical practice, and their clinical effectiveness in patients with ASCVD and hypercholesterolemia and patients with FH is scarce. Therefore, a multidisciplinary working group of cardiologists, family physicians, internal medicine specialists and neurologists was gathered for the Reality study. The aim of this study is to describe the demographic and clinical characteristics, comorbidities, and concomitant medication of patients with ASCVD and hypercholesterolemia and of patients with familial hypercholesterolemia (FH). The use of healthcare resources and costs associated to the management of these diseases after their diagnosis were also considered.MethodsThis is an observational and retrospective study, based on the BIG-PAC® database, which includes the electronic medical registries (EMRs) of 1.8 million people from 7 Autonomous Communities in Spain (including public primary care centers and hospitals). The study includes patients who had a new or recurrent episode of ASCVD during the recruitment period (from 01/01/2017 to 31/12/2018). The index date will be defined as the date of the ASCVD event, and the follow-up period will be 24 months. According to their first diagnosis in the database, patients will be classified as ASCVD (5 groups: stable/unstable angina, acute myocardial infarction, ischemic stroke, transient ischemic attack, and peripheral arterial disease) or FH.DiscussionThis study aims to analyze the treatment patterns and use of healthcare resources of ASCVD and FH in Spain. The prevalence of these disorders will also be estimated. Due to the high morbidity and mortality associated with these diseases, it is expected that our study will provide useful information for healthcare systems and decision makers to improve the management of these disabling diseases.

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“…Despite guidelines recommending high-intensity statins, the EUROASPIRE study reported that, in Europe, about 10% of patients with established CHD did not have a statin prescription at discharge, about 62.4% started on low- or medium-intensity statins, and this proportion only increased to 67.3% after 1 year ( 38 , 39 ). This suboptimal prescription is of concern if we take into account that the risk of recurrent CV events, CV mortality and also all-cause mortality decrease in parallel with the potency of the statin used ( 39 , 40 ).…”

Section: Secondary Prevention In Chronic Cardiovascular Diseasementioning

confidence: 99%

Practical Decision Algorithms for the Use of the Cardiovascular Polypill in Secondary Prevention in Europe

Grigorian-Shamagian

Edel

Esteve‐Pastor

et al. 2021

Front. Cardiovasc. Med.

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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.

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Number of drugs used in secondary cardiovascular prevention and late survival in the population of Valencia Community, Spain

Cited by 8 publications

References 31 publications

Impact of adherence to drugs for secondary prevention on mortality and cardiovascular morbidity: A population‐based cohort study. IMPACT study

Impact of adherence to drugs for secondary prevention on mortality and cardiovascular morbidity: A population‐based cohort study. IMPACT study

Treatment patterns and use of healthcare resources of patients with atherosclerotic cardiovascular disease and hypercholesterolemia and patients with familial hypercholesterolemia in Spain: Protocol of the Reality study

Practical Decision Algorithms for the Use of the Cardiovascular Polypill in Secondary Prevention in Europe

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