ArticleJournal of the American College of Cardiology2014
Polypill therapy, subclinical atherosclerosis, and cardiovascular events-implications for the use of preventive pharmacotherapy: MESA (Multi-Ethnic Study of Atherosclerosis).
Article in Journal of the American College of Cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Fixed-dose combination therapy for the prevention of atherosclerotic cardiovascular diseases.The Cochrane database of systematic reviews · 2017Pooled it
- Comparative analysis of high-sensitivity cardiac troponin I and T for their association with coronary computed tomography-assessed calcium scoring represented by the Agatston score.European journal of medical research · 2017Trial
- Coronary Plaque Morphology and the Anti-Inflammatory Impact of Atorvastatin: A Multicenter 18F-Fluorodeoxyglucose Positron Emission Tomographic/Computed Tomographic Study.Circulation. Cardiovascular imaging · 2016Trial
- Radiomics Signature of Aging Myocardium in Cardiac Photon-Counting Computed Tomography.Diagnostics (Basel, Switzerland) · 2025Article
- Mapping clinical and imaging factors that might predict cardiac events in breast cancer patients.Frontiers in oncology · 2025Article
- Cardiovascular Computed Tomography and Magnetic Resonance Imaging Guideline of the Brazilian Society of Cardiology and the Brazilian College of Radiology - 2024.Arquivos brasileiros de cardiologia · 2024Article
- Growth differentiation factor-15 predicts all-cause death and major adverse cardiovascular events in patients with coronary heart disease: a prospective cohort study.Journal of thrombosis and thrombolysis · 2024Article
- Frontiers of cardiovascular polypills: From atherosclerosis and beyond.Trends in cardiovascular medicine · 2023Review
- Earlier treatment in adults with high lifetime risk of cardiovascular diseases: What prevention trials are feasible and could change clinical practice? Report of a National Heart, Lung, and Blood Institute (NHLBI) Workshop.American journal of preventive cardiology · 2022Review
- Myocardial Radiomics Texture Features Associated with Increased Coronary Calcium Score-First Results of a Photon-Counting CT.Diagnostics (Basel, Switzerland) · 2022Article
- Accurate Measurement of Agatston Score Using kVp-Independent Reconstruction Algorithm for Ultra-High-Pitch Sn150 kVp CT.Korean journal of radiology · 2021Article
- Polypills in Cardiovascular Disease Prevention: Mass-Strategy Approach, Precision Medicine, or an Essential Intertwine Between Them?Current atherosclerosis reports · 2021Review
- Polypill for Population-Level Primary Cardiovascular Prevention in Underserved Populations-A Social Epidemiology Counterargument.The American journal of medicine · 2020Article
- Evaluation of an AI-based, automatic coronary artery calcium scoring software.European radiology · 2020Observational
- Association of mineral content outside of bone with coronary artery calcium and 1-year cardiovascular prognosis in maintenance hemodialysis patients.Artificial organs · 2019Article
- [Management of different cardiovascular risk factors with a combination tablet (polypill)].Herz · 2018Review
- Statin Trials, Cardiovascular Events, and Coronary Artery Calcification: Implications for a Trial-Based Approach to Statin Therapy in MESA.JACC. Cardiovascular imaging · 2018Article
- Coronary Artery Calcium Score for Long-term Risk Classification in Individuals With Type 2 Diabetes and Metabolic Syndrome From the Multi-Ethnic Study of Atherosclerosis.JAMA cardiology · 2017Article
- Strengths and Limitations of Using the Polypill in Cardiovascular Prevention.Current cardiology reports · 2017Review
- Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association.Circulation · 2017Review
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesThis study examines whether the coronary artery calcium (CAC) score can be used to define the target population to treat with a polypill.
backgroundPrior studies have suggested a single polypill to reduce cardiovascular disease (CVD) at the population level.
methodsParticipants from MESA (Multi-Ethnic Study of Atherosclerosis) were stratified using the criteria of 4 polypill studies (TIPS [The Indian Polycap Study], Poly-Iran, Wald, and the PILL [Program to Improve Life and Longevity] Collaboration). We compared coronary heart disease (CHD) and CVD event rates and calculated the 5-year number needed to treat (NNT) after stratification based on the CAC score.
resultsAmong MESA participants eligible for TIPS, Poly-Iran, Wald, and the PILL Collaboration, CAC = 0 was observed in 58.6%, 54.5%, 38.9%, and 40.8%, respectively. The rate of CHD events among those with CAC = 0 varied from 1.2 to 1.9 events per 1,000 person-years, those with CAC scores from 1 to 100 had event rates ranging from 4.1 to 5.5, and in those with CAC scores >100 the event rate ranged from 11.6 to 13.3. The estimated 5-year NNT to prevent 1 CVD event ranged from 81-130 for patients with CAC = 0, 38-54 for those with CAC scores from 1 to 100, and 18-20 for those with CAC scores >100.
conclusionsIn MESA, among individuals eligible for treatment with the polypill, the majority of CHD and CVD events occurred in those with CAC scores >100. The group with CAC = 0 had a very low event rate and a high projected NNT. The avoidance of treatment in individuals with CAC = 0 could allow for significant reductions in the population considered for treatment, with a more selective use of the polypill and, as a result, avoidance of treatment in those who are unlikely to benefit.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.