Highlights
- •Effect of statins for primary prevention was analyzed in individuals aged >75 years.
- •Statin was associated with lower cardiovascular risk and all-cause death.
- •Rates of MI and coronary revascularization were lower in statin users.
- •These results support a more active statin use in this population.
Abstract
Background and aims
Limited data is available on the benefit of statin for primary prevention in the elderly.
The aim of this study is to investigate whether statin for primary prevention is effective
in lowering the cardiovascular risk and all-cause death in individuals aged >75 years.
Methods
This was a retrospective, propensity score-matched study and data were acquired between
2005 and 2016 in a tertiary university hospital. Of the 6414 patients screened, 1559
statin-naïve patients without a history of atherosclerotic cardiovascular disease
before the index visit were included. After propensity score matching, 1278 patients
(639 statin users, 639 statin non-users) were finally analyzed. Primary outcome variables
included major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause
death. MACCE included cardiovascular death, nonfatal myocardial infarction, coronary
revascularization, and nonfatal stroke or transient ischemic attack.
Results
At a median follow-up of 5.2 years, statin users had lower rates of MACCE (2.15 vs. 1.25 events/100 person-years; hazard ratio, 0.59; p = 0.005) and all-cause death (1.19 vs. 0.65 events/100 person-years; hazard ratio, 0.56; p = 0.02), as well as lower levels of low-density lipoprotein-cholesterol than did
non-users. The Kaplan-Meier curves revealed lower event rates in statin users (hazard
ratio: 0.59 for MACCE and 0.56 for all-cause death). The incidence of myocardial infarction
and coronary revascularization were lower in statin users.
Conclusions
Statin therapy for primary prevention was clearly associated with lower risk of cardiovascular
events and all-cause death in individuals aged >75 years. These results support more
active statin use in this population.
Graphical abstract
Graphical Abstract
Keywords
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Article Info
Publication History
Published online: March 04, 2019
Accepted:
February 27,
2019
Received in revised form:
February 22,
2019
Received:
November 5,
2018
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
