Evidence map›Paper›PMID 42393373›Full record

Trial reportNature medicine2026

Polypill for heart failure with reduced ejection fraction: the POLY-HF randomized trial.

Ambarish Pandey, Neil Keshvani, Syed K Rizvi, Fatemeh Khashami, Katarina Yaros, Muhammad Shariq Usman, Matthew W Segar, Anand K Jain, Juan David Coellar, Myriam Bustillo-Rubio and 9 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04633005 (Polypill Strategy for the Evidence-Based Management of Heart Failure With Reduced Ejection Fraction in an Underserved Patient Population), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

NCT04633005 phase2completednot on this map

Polypill Strategy for the Evidence-Based Management of Heart Failure With Reduced Ejection Fraction in an Underserved Patient Population

TypeinterventionalSponsorUniversity of Texas Southwestern Medical CenterRan2021 to 2025Enrolled212ConditionsHeart FailureArmsPolypill, Control Rx
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Ambarish PandeyDepartment of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA. ambarish.pandey@utsouthwestern.edu.ORCID http://orcid.org/0000-0001-9651-3836
Neil Keshvani *Department of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
Syed K Rizvi *Department of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
Fatemeh KhashamiAdvanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA.
Katarina YarosDepartment of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
Muhammad Shariq UsmanDepartment of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
Matthew W SegarDepartment of Cardiology, Texas Heart Institute, Houston, TX, USA.
Anand K JainDepartment of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.ORCID http://orcid.org/0009-0006-3432-2667
Juan David CoellarDepartment of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
Myriam Bustillo-RubioDepartment of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
Zachary L CoxDepartment of Pharmacy Practice and Pharmaceutical Science, Lipscomb University College of Pharmacy, Nashville, TN, USA.ORCID http://orcid.org/0000-0002-4919-0146
Jennifer T ThibodeauDepartment of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
Chul AhnDepartment of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
Deepak K GuptaDivision of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Alvin ChandraDepartment of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
Mark H DraznerDepartment of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
M Tarique HussainDepartment of Pediatrics, Division of Pediatric Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Vlad G ZahaDepartment of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.ORCID http://orcid.org/0000-0003-4878-891X
Thomas J WangUniversity of Michigan Medical School, Ann Arbor, MI, USA.ORCID http://orcid.org/0000-0003-4063-6508

Funding

Polypill strategy for the evidence-based management of heart failure with reduced ejection fraction in an underserved patient populationR01MD017529 · NIMHD · UT SOUTHWESTERN MEDICAL CENTER · PI PANDEY, AMBARISH, WANG, THOMAS J. · 2022 to 2025
$2.9M
NIMHD NIH HHS R01 MD017529U.S. Department of Health & Human Services | NIH | National Institute on Minority Health and Health Disparities (NIMHD) R01MD017529
6 · The paper itself

Abstract

Heart failure with reduced ejection fraction carries a poor prognosis. Although guideline-directed medical therapy reduces morbidity and mortality, its real-world utilization is low. Accordingly, we conducted an open-label randomized trial (POLY-HF) at two centers enrolling a predominantly underserved population to test whether a polypill strategy improves cardiac function in heart failure. Adults with heart failure and left ventricular ejection fraction ≤40% were randomized to a once-daily polypill containing metoprolol succinate (25/50/100/150 mg), spironolactone 12.5 mg and empagliflozin 10 mg, or rapid uptitration of individual guideline-directed medical therapy medications ('enhanced usual care'). Participants also continued treatment with a renin-angiotensin system inhibitor or sacubitril/valsartan as a separate pill. The primary endpoint was ejection fraction as assessed by cardiac magnetic resonance imaging at 6 months. Secondary endpoints included clinical outcomes and adherence. We randomized 212 patients (median age 54 years, 22% female, 54% Black). Follow-up magnetic resonance imaging data were available for 187 (88%) participants who were included in the modified intention-to-treat analysis. Polypill treatment was associated with greater improvement in ejection fraction compared to enhanced usual care (between-group difference, 3.3 percentage points, 95% confidence interval, 0.2-6.4; P = 0.039), meeting the primary outcome. Individuals randomized to the polypill also had a 60% lower rate of heart failure hospitalizations or emergency department visits (adjusted rate ratio, 0.40; 95% confidence interval, 0.18-0.88; P = 0.024). Adherence, assessed by blood concentrations of metoprolol and spironolactone, was higher with polypill treatment than with enhanced usual care (79% versus 54%, P = 0.001). The polypill was well tolerated, with fewer adverse events with polypill treatment as compared to enhanced usual care. A polypill for heart failure was associated with a significant improvement in cardiac function as compared with enhanced usual care. ClinicalTrials.gov registration: NCT04633005 .

Indexed as

Heart FailureStroke VolumeAgedAminobutyratesBenzhydryl CompoundsBiphenyl CompoundsDrug CombinationsFemaleHumansMaleMetoprololMiddle AgedSpironolactoneTetrazolesTreatment OutcomeValsartanAminobutyratesBenzhydryl CompoundsBiphenyl CompoundsDrug CombinationsMetoprololsacubitril and valsartan sodium hydrate drug combinationSpironolactoneTetrazolesValsartan

Identifiers

PMID42393373
PMCPMC13472951

What Socratic holds

Textmetadata
Read underepoch 390

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 Socratic graph.