OBJECTIVES: To examine the effect of statins on long-term mortality in older adults hospitalized with coronary artery disease (CAD). DESIGN: Retrospective analysis. SETTING: University teaching hospital. PARTICIPANTS: Individuals aged 80 and older (mean aged 85.2, 56% female) hospitalized from January 2006 to December 2010 with acute myocardial infarction (AMI), unstable angina pectoris, or chronic CAD and discharged alive (N = 1,262). Participants were divided into those who did (n = 913) and did not (n = 349) receive a discharge prescription for a statin. MEASUREMENTS: All-cause mortality over a median follow-up of 3.1 years. RESULTS: Participants treated with statins were more likely to be male, to have a primary diagnosis of AMI, to have traditional cardiovascular risk factors, and to receive other standard cardiovascular medications in addition to statins. In unadjusted analysis, statin therapy was associated with lower mortality (hazard ratio (HR) = 0.83, 95% confidence interval (CI) = 0.71-0.96). After adjustment for baseline differences between groups and propensity for receiving statin therapy, the effect of statins on mortality was no longer significant (HR = 0.88, 95% CI = 0.74-1.05). The association between statins and mortality was similar in participants aged 80 to 84 and those aged 85 and older. CONCLUSION: In this cohort of older adults hospitalized with CAD, statin therapy had no significant effect on long-term survival after adjustment for between-group differences. These findings, although preliminary, call into question the benefit of statin therapy for secondary prevention in a real-world population of adults aged 80 and older and underscore the need for shared decision-making when prescribing statins in this age group.
OBJECTIVES: To examine the effect of statins on long-term mortality in older adults hospitalized with coronary artery disease (CAD). DESIGN: Retrospective analysis. SETTING: University teaching hospital. PARTICIPANTS: Individuals aged 80 and older (mean aged 85.2, 56% female) hospitalized from January 2006 to December 2010 with acute myocardial infarction (AMI), unstable angina pectoris, or chronic CAD and discharged alive (N = 1,262). Participants were divided into those who did (n = 913) and did not (n = 349) receive a discharge prescription for a statin. MEASUREMENTS: All-cause mortality over a median follow-up of 3.1 years. RESULTS:Participants treated with statins were more likely to be male, to have a primary diagnosis of AMI, to have traditional cardiovascular risk factors, and to receive other standard cardiovascular medications in addition to statins. In unadjusted analysis, statin therapy was associated with lower mortality (hazard ratio (HR) = 0.83, 95% confidence interval (CI) = 0.71-0.96). After adjustment for baseline differences between groups and propensity for receiving statin therapy, the effect of statins on mortality was no longer significant (HR = 0.88, 95% CI = 0.74-1.05). The association between statins and mortality was similar in participants aged 80 to 84 and those aged 85 and older. CONCLUSION: In this cohort of older adults hospitalized with CAD, statin therapy had no significant effect on long-term survival after adjustment for between-group differences. These findings, although preliminary, call into question the benefit of statin therapy for secondary prevention in a real-world population of adults aged 80 and older and underscore the need for shared decision-making when prescribing statins in this age group.
Authors: Michael A Campitelli; Colleen J Maxwell; Laura C Maclagan; Dennis T Ko; Chaim M Bell; Lianne Jeffs; Andrew M Morris; Kate L Lapane; Nick Daneman; Susan E Bronskill Journal: CMAJ Date: 2019-01-14 Impact factor: 8.262
Authors: Marco Bertolotti; Carlotta Franchi; Marco B L Rocchi; Andrea Miceli; M Vittoria Libbra; Alessandro Nobili; Giulia Lancellotti; Lucia Carulli; Chiara Mussi Journal: Drugs Aging Date: 2017-04 Impact factor: 3.923
Authors: Alberto Pilotto; Pietro Gallina; Francesco Panza; Massimiliano Copetti; Alberto Cella; Alfonso Cruz-Jentoft; Julia Daragjati; Luigi Ferrucci; Stefania Maggi; Francesco Mattace-Raso; Marc Paccalin; Maria Cristina Polidori; Eva Topinkova; Gianluca Trifirò; Anna-Karin Welmer; Timo Strandberg; Niccolò Marchionni Journal: Am J Cardiol Date: 2016-08-30 Impact factor: 2.778
Authors: Geert J Lefeber; Huiberdina L Koek; Patrick C Souverein; Marcel L Bouvy; Anthonius de Boer; Wilma Knol Journal: J Am Geriatr Soc Date: 2019-10-24 Impact factor: 5.562