A polypill is a medication drug that comprises multiple active pharmaceutical ingredients. A polypill consisting of statins, blood pressure-lowering drugs, and aspirin is known to reduce the risk of cardiovascular disease in patients without cardiovascular disease. But whether the polypill without aspirin can elicit the desired effect is not clear. This study aims to compare the efficacy of polypill with or without aspirin in patients with cardiovascular disease.

This randomized trial included a total of 5,713 patients without cardiovascular disease who were at a higher risk of a cardiovascular event as estimated by an elevated INTERHEART Risk Score. The patients were randomly assigned to receive polypill or placebo. The primary outcome of the study was death from cardiovascular causes.

During a mean follow-up of 4.6 years, the LDL cholesterol level was lower by 19 mg per dL, and the systolic blood pressure was lowered by 5.8 mm Hg in the polypill group when compared with placebo. The primary polypill comparison outcome occurred in 126 participants in the polypill group and 157 patients in the placebo group.

Polypill treatment with aspirin was associated with a lower incidence of cardiovascular events than placebo in patients without cardiovascular disease.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa2028220