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Statin and clinical outcomes of primary prevention in individuals aged >75 years: The SCOPE-75 study

  • Kyu Kim
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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  • Chan Joo Lee
    Affiliations
    Department of Health Promotion, Yonsei University College of Medicine, Seoul, South Korea
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  • Chi-Young Shim
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Jung-Sun Kim
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Byeong-Keuk Kim
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Sungha Park
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Hyuk-Jae Chang
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Geu-Ru Hong
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Young-Guk Ko
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Seok-Min Kang
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Donghoon Choi
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Jong-Won Ha
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Myeong-Ki Hong
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Yangsoo Jang
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Sang-Hak Lee
    Correspondence
    Corresponding author. Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752, South Korea.
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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      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

      Keywords

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