cardiovascular disease
DISEASE INTERVENTION COMPARISON RESULTS
Heart. 2018 Mar 23. doi: 10.1136/heartjnl-2017-312571. [Epub ahead of print] Systematic Review
IN therapeutics, adherence to drug treatment, cardiovascular disease The Use of
3 interventions: short message service, fixed-dose combination pill, community health worker intervention
As Treatment, Acute
Is better Than
usual care
To improve medication adherence: 44% to 99% in the intervention groups VS 13% to 96% in usual care groups
JAMA. 2006 Feb 8;295(6):655-66 Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention The Use of
intensive dietary intervention to reduce fat intake and increased intakes of vegetables, fruits, and grains
As Prevention, Primary
Is equal Than
providing diet-related education materials
To reduce at 8 years coronary heart disease (0.64% both groups), stroke (0.27%), in spite of mild reductions in fat intake and blood lipids
Cochrane Database Syst Rev. 2012;5:CD002137 Systematic Review, Cochrane Review
IN atherosclerosis, cardiovascular disease, primary prevention The Use of
reduction of dietary saturated fat by partially replacing by unsaturatef fats
As Prevention, Primary
Is better Than
no modification of diet
To modestly reduce cardiovascular events (RR 0.86) but not to reduce total or cardiovascular mortality
Cochrane Database Syst Rev. 2013;1:CD004816 Systematic Review, Cochrane Review
IN atherosclerosis, cardiovascular disease, primary prevention The Use of
statins
As Prevention, Primary
Is better Than
placebo
To reduce all cause mortality (OR 0,86), and cardiovascilar death and events (OR 0,73 to 0,78), after at least 1 year of treatment
N Engl J Med. 2013 Apr 4;368(14):1279-90 Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients The Use of
Mediterranean diet supplemented with extra-virgin olive oil, or with mixed nuts
As Prevention, Primary
Is better Than
simple advice to reduce dietary fat
To reduce cardiovascular events (myocardial infarction, stroke, or cardiovascular death) : HR 0.70
BMJ. 2014;349(iss):g4379 Meta-Analysis
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, high cholesterol The Use of
drug treatments targeted to increase high density lipoprotein: niacin, fibrates, and cholesteryl ester transfer protein (CETP) inhibitors
As Prevention, Primary
Is equal Than
placebo or no treatment
To modify cardiovascular events (all cause mortality, coronary heart disease mortality, non-fatal myocardial infarction, and stroke)
JAMA. 2014 Sep 17;312(11):1136-44 Systematic Review
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, high cholesterol, older patients The Use of
statins
As Prevention, Primary
Is undefined Than
no statin treatment
To reduce cardiovascular events. No RCT in patients older than 80 years was found
Lancet. 2002 Nov 23;360(9346):1623-30 Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, high cholesterol, older patients The Use of
statins, pravastatin 40 mg/d
As Prevention, Primary
Is better Than
placebo
To to reduce at 3 years cardiovascular events: 14% pravastatine VS 16% placebo. Reduction was due to reduction in non-fatal myocardial infaction, no significant difference in stroke and death
J Am Coll Cardiol. 2013 Dec 3;62(22):2090-9 Meta-Analysis
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, older patients The Use of
statins
As Prevention, Primary
Is better Than
placebo
To reduce myocardial infarction (RR 0.60) and stroke (RR 0.76) but it did not reduced mortality (either total or cardiovascular)
N Engl J Med. 2016 May 26;374(21):2021-31 Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, intermediate risk patients, normal or high cholesterol The Use of
statins, rosuvastatin 10 mg/day for > 5 years
As Prevention, Primary
Is better Than
placebo
To reduce cardiovascular events (cardiovascular death, nonfatal myocardial infarction or stroke) at 5.6 years: 3.7% rosuvastatin VS 4.8% placebo. No difference in mortality: 2.8-2.9% both. Muscle symptoms in 5.8% of patients on rosuvastatin.
JAMA Intern Med. 2017 Jul 01;177(7):955-965 Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, low to moderate risk patients, older patients The Use of
statin, pravastatin, 40 mg/d
As Prevention, Primary
Is equal Than
usual care
To modify, after 6 years, mortality or coronary disease
N Engl J Med. 2008 Nov 20;359(21):2195-207 Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, normal cholesterol, elevated C-reactive protein The Use of
statins, rosuvastatin
As Prevention, Primary
Is better Than
placebo
To reduce the incidence of major cardiovascular events at 2 years: 0.77% per year statin VS 1.4% per year placebo.
JAMA. 2011 Mar 2;305(9):913-22 Meta-Analysis
IN cardiovascular death, atherosclerosis, patients with a history of cardiovascular disease or diabetes but without hypertension The Use of
antihypertensive drugs, no information at all about which specific antihypertensive drugs were studied
As Treatment, Chronic
Is better Than
placebo
To reduce stroke (RR 0.77, NNT 129), myocardial infarction (RR 0.80, NNT 75), heart failure (RR 0.85, NNT 23), and all-cause mortality (RR 0.87, NNT 75)
JAMA. 2013 Sep 4;310(9):918-29 Randomized Controlled Trial, Multicenter Study
IN cardiovascular disease The Use of
polypill, fixed-dose combinations of drugs, 75 mg aspirin, 40 mg simvastatin, 10 mg lisinopril, and 50 mg atenolol
As Prevention, Primary
Is better Than
usual care
To improve medication adherence (86% polypill VS 65% usual) and statistically significant but small improvements in blood pressure and LDL-C
Cochrane Database Syst Rev. 2014;4:CD009868 Systematic Review, Cochrane Review
IN cardiovascular disease, cardiovascular death The Use of
polypill, fixed-dose combinations of drugs
As Treatment, Chronic
Is equal Than
Comparison to be defined
To cardiovascular mortality and cardiovascular events. Reductions in blood pressure and lipid parameters are generally lower than those previously projected.
N Engl J Med. 2008 Feb 7;358(6):580-91 Randomized Controlled Trial
IN diabetes mellitus, type 2, microalbuminuria, cardiovascular disease The Use of
intensified multifactorial intervention: tight glucose control plus use of renin-angiotensin system blockers, aspirin, and lipid-lowering agents (statins)
As Treatment, Chronic
Is better Than
usual (conventional) therapy
To reduce, at 13 years, all-cause mortality (30% multifactorial Tt VS 50% usual Tt), cardiovascular events (HR 0.54) and advenced reanl disease.
N Engl J Med. 2015 Nov 26;373(22):2117-28 Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2, patients with cardiovascular disease The Use of
renal sodium-glucose cotransporter inhibitor, gliflozins, empagliflozin, on top or in substitution of previous antidiabetes Tt
As Treatment, Chronic
Is better Than
placebo
To reduce death from cardiovascular causes (3.7% empag VS 5.9% placebo), death from any cause (5.7% VS 8.3% placebo) and hospitalization for heart failure (2.7% VS 4.1% placebo)