Gestión terapéutica con policomprimido CNIC al alta de un primer síndrome coronario agudo en España: el estudio PANDORA

Abstract

Introduction and objectives

The polypill from the Spanish National Centre for Cardiovascular Diseases (CNIC) contains drugs (acetylsalicylic acid/atorvastatin/ramipril) for adequate secondary prevention after acute coronary syndrome (ACS). The aim was to describe the 6-month management of drugs with an effect on cardiovascular prognosis in patients treated with CNIC polypill as a baseline treatment at discharge after a first ACS.

Methods

Observational, ambispective, multicenter, national study, according to standard clinical practice. Changes in baseline and adjuvant treatment were evaluated, as well as cardiovascular risk factors.

Results

In total, 288 patients were included and 285 were valid for analysis. Among them, 17.9% were women and the mean age was 62.2 (12.4) years. The most prescribed formulation of the CNIC polypill was 100 mg/40 mg/2.5 mg (55.8%). Of the participants, 76.5% maintained the baseline treatment prescribed at discharge. Also, in 8.8% of patients the dose was increased to optimize the treatment and in 3.5% decreased due to the need of therapeutic optimization or the appearance of side effects. All participants reported some adjuvant treatment, mainly antihypertensives (34.9%) and lipid-lowering agents (28.2%). A significant decrease in mean low-density lipoprotein cholesterol was observed between discharge and the following 2 visits (P < .0001).

Conclusions

After a first ACS, the treatment with CNIC polypill at discharge is effective and safe. CNIC polypill therapy remained unchanged as baseline treatment in most patients. Dose was increased or, at least, an adjuvant treatment was added according to standard clinical practices when it was required.