Six Month Polypill Therapy Improves Lipid Profile in Patients with Previous Acute Myocardial Infarction: The Heart-Mex Study

Abstract

Acute myocardial infarction (AMI) is a leading cause of death in Mexico. Atherogenic lipid profile is a key component in AMI. Thus, it is imperative to find drug therapies able to reduce atherogenic lipids in AMI patients and prevent subsequent myocardial infarctions. To investigate the effect of polypill (Sincronium®) alone or combined with beta blockers (BB) and/or thiazide diuretics (TD) on total cholesterol, triglycerides, low-density lipoproteins (LDL), high-density lipoproteins (HDL), and cardiovascular risk markers in a Mexican population with AMI. Secondary AMI-prevention patients (n=256) were included in the study and categorized into three groups depending on the drug scheme, as follows: polypill (n=150), polypill+BB (n=91), and polypill+ BB+ TD (n=15). Lipid profile and cardiovascular risk markers were evaluated in each patient before and 6months after drug therapy. The Wilcoxon-matched pairs signed rank test showed significant ∼25-30% reductions in total cholesterol, triglycerides, and LDL in the polypill group as compared to polypill+ BB and polypill+ BB+ TD groups. On the contrary, HDL was significantly increased in polypill and polypill+ BB groups. Polypill therapy showed more marked reductions in blood pressure, atherogenic index, Framingham risk score, and vascular age with respect to polypill+ BB and polypill+ BB+ TD groups. This study demonstrates for the first time that polypill therapy without being combined with BB and TD is effective to improve the atherogenic lipid profile and cardiovascular risk markers in AMI patients. Further studies are needed to examine the efficacy of polypill in reducing the occurrence of a second AMI in the Mexican population.