Masahiro Natsuaki1, Takeshi Morimoto2, Yutaka Furukawa3, Hiroki Shiomi4, Koh Ono4, Takeshi Kimura5. 1. Division of Cardiology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan. 2. Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan. 3. Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan. 4. Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 5. Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: taketaka@kuhp.kyoto-u.ac.jp.
Abstract
OBJECTIVE: Effects of statin therapy on cardiovascular outcomes in super-elder population ≥ 80 years of age have been poorly understood, despite its established role in non-super-elder population. METHODS: Among 14,834 patients undergoing first coronary revascularization in the CREDO-Kyoto Registry Cohort-2, patients were divided into 2 strata based on age and patients in each stratum were further divided into 2 groups based on statin therapy at discharge; ≥ 80 years of age: 2017 patients (statin group: N = 765, no-statin group: N = 1252) and <80 years of age: 12,817 patients (statin group: N = 6523, no-statin group: N = 6294). RESULTS: Through 5-year follow-up, cumulative incidences of major adverse cardiovascular events (MACE: composite of cardiovascular death, myocardial infarction and stoke) were significantly lower in the statin group than in the no-statin group in both strata (23.4% versus 32.0%, P = 0.0003 in patients ≥ 80 years of age and 11.5% versus 16.1%, P < 0.0001 in patients <80 years of age). After adjusting confounders, statin therapy was associated with significantly reduced risk for MACE not only in patients <80 years of age (hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.74-0.91, P < 0.0001), but also in patients ≥ 80 years of age (HR 0.77, 95% CI 0.64-0.93, P = 0.006). There was no interaction between age and the effect of statins (P interaction = 0.86). CONCLUSIONS: Statin therapy at discharge from first coronary revascularization was associated with significantly reduced risk for cardiovascular events even in patients ≥ 80 years of age. There was no difference in the direction and magnitude of treatment effect of statins between the super-elder and non-super-elder patients.
OBJECTIVE: Effects of statin therapy on cardiovascular outcomes in super-elder population ≥ 80 years of age have been poorly understood, despite its established role in non-super-elder population. METHODS: Among 14,834 patients undergoing first coronary revascularization in the CREDO-Kyoto Registry Cohort-2, patients were divided into 2 strata based on age and patients in each stratum were further divided into 2 groups based on statin therapy at discharge; ≥ 80 years of age: 2017 patients (statin group: N = 765, no-statin group: N = 1252) and <80 years of age: 12,817 patients (statin group: N = 6523, no-statin group: N = 6294). RESULTS: Through 5-year follow-up, cumulative incidences of major adverse cardiovascular events (MACE: composite of cardiovascular death, myocardial infarction and stoke) were significantly lower in the statin group than in the no-statin group in both strata (23.4% versus 32.0%, P = 0.0003 in patients ≥ 80 years of age and 11.5% versus 16.1%, P < 0.0001 in patients <80 years of age). After adjusting confounders, statin therapy was associated with significantly reduced risk for MACE not only in patients <80 years of age (hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.74-0.91, P < 0.0001), but also in patients ≥ 80 years of age (HR 0.77, 95% CI 0.64-0.93, P = 0.006). There was no interaction between age and the effect of statins (P interaction = 0.86). CONCLUSIONS: Statin therapy at discharge from first coronary revascularization was associated with significantly reduced risk for cardiovascular events even in patients ≥ 80 years of age. There was no difference in the direction and magnitude of treatment effect of statins between the super-elder and non-super-elder patients.
Authors: Cédric Villain; Sophie Liabeuf; Marie Metzger; Christian Combe; Denis Fouque; Luc Frimat; Christian Jacquelinet; Maurice Laville; Serge Briançon; Ronald L Pisoni; Nicolas Mansencal; Bénédicte Stengel; Ziad A Massy Journal: Clin Kidney J Date: 2019-06-10