Adherencia farmacológica y prevención secundaria cardiovascular: una de las principales barreras en el tratamiento de la enfermedad ateroesclerótica: posición del Departamento de Prevención Cardiovascular de SOCHICAR en el uso de la polipíldora en prevención secundaria / Adherence to pharmacologic treatment in secondary prevention of cardiovascular disease

This paper outlines the position of the Department of Cardiovascular Prevention from the Chilean Society of Cardiology regarding the use of the "polypill". The international and local evidence regarding the benefits of the polypill compared to conventional therapy is reviewed. The benefits and some limitations of the polypill are outlined, along with cost-effective considerations. The increased adherence to treatment and the better clinical results of this strategy are put forward. The used of the polypill in different groups of subjects, especially those recovered from a recent myocardial in-farction, is recommended for individual patients and in Chilean cardiovascular prevention programs from the Ministry of Health.

[Results of the first Chilean registry of unstable angina. Clinical features, risk profile and treatment]. / Resultados del primer registro chileno de angina inestable: características clínicas, perfil de riesgo y tratamiento.

BACKGROUND: From January 2000 to June 2002, the first Chilean registry of unstable angina was carried out, with the participation of 15 hospitals. AIM: To report the clinical and demographic features of 600 patients with unstable angina, their risk profile and prognosis. MATERIAL AND METHODS: The inclusion criteria for this prospective registry were a history of recent onset of chest pain (<48 hours) or a change in the character of previous angina, associated to ischemic electrocardiographic changes and/or positive markers of myocardial damage. RESULTS: Mean age of the patients was 65 years and 37% were women. Among coronary risk factors, 63% had hypertension, 27% had diabetes, 52% had dyslipidemia, 31% smoked and 21% had a family history of atherosclerosis. On admission 94% of patients had chest pain, associated to ST segment depression in 44%, negative T waves in 28% and positive markers of myocardial damage in 30%. Fifty seven percent received intravenous nitroglycerin, 47% received oral nitrates, 69% beta blockers and 15%, calcium antagonists. Antithrombotic therapy included aspirin in 96%, heparin in 74%, ticlodipine or clopidogrel in 19% and IIb/IIIa inhibitors in 12%. A coronary angiogram was performed in 52%, angioplasty in 25% and coronary bypass surgery in 13%. Hospital mortality was 2.6%. The incidence of new ischemic events was: myocardial infarction in 2.8% recurrent ischemia in 9.5% and refractory ischemia in 2%. The incidence of adverse events increased according to a higher risk profile. CONCLUSIONS: The demographic and clinical features, treatment and mortality of these patients are similar to those reported in international registries, with a low mortality rate.