Nature reviews. Cardiology
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The effect of a fixed-dose combination drug strategy ('polypill') on patients' adherence to medication was analysed in a series of 2,004 individuals with, or at high risk of, cardiovascular disease in the UMPIRE study. The polypill improved adherence by >20%, but the reduction in blood-pressure and cholesterol levels was modest.
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Patients with severe aortic stenosis who are at high surgical risk or not considered to be suitable candidates for surgical aortic valve replacement are increasingly being treated with transcatheter aortic valve replacement (TAVR). Although this novel treatment modality has been proven to be effective in this patient population, serious complications occur in approximately one-third of patients during the month after the procedure. ⋯ Anticipation and early recognition of these complications, followed by prompt management using a wide range of percutaneous or surgical rescue interventions, is vital to patient outcome. Continuous patient assessment and reporting of complications according to standardized definitions, in addition to growing operator experience and upcoming technological refinements, will hopefully reduce the future rate of complications related to this procedure.