Study Shows Statins Reduce MI and Stroke in High CV Risk Elderly

In elderly patients with high cardiovascular risk without established cardiovascular disease, statins reduced the incidence of a myocardial infarction (MI) and stroke in a short-term follow-up, however there was a non-significant trend in mortality reduction, according to the results of a study published Aug. 28 in the Journal of the American College of Cardiology .

"Studies like this are very important in terms of cardiovascular prevention in older adults because it shows the efficacy that's so strong. Dr. Water's editorial points out that this type of efficacy was expected but it really hasn't been well demarcated in relation to age," said Daniel Forman, MD, FACC.

The study — a meta-analysis of eight randomized trials with 24,674 patients ages 65 and older — showed that statins, compared to placebo, significantly reduced the risk of MI by 39.4 percent (p=0.003), as well as the risk of stroke by 23.8 percent (p=0.006). However, the risk of all-cause death (p=0.210) and of cardiovascular death (p=0.493) were not significantly reduced.

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The authors note that their meta-analysis provides "first time evidence that the benefits of statins on major cardiovascular events extend to people ≥ 65 years without cardiovascular disease." However, they add that the "cost-benefit evaluation of treatment in elderly people must be considered."

In an editorial comment, David Waters, MD, FACC, division of cardiology, San Francisco General Hospital, writes that "the decision to treat or not treat an older individual with a statin often requires clinical discernment. The clear result of this meta-analysis will hopefully lead to more older individuals receiving treatment that will reduce their cardiovascular risk."

Clinical Topics: Clinical Topic Collection: Dyslipidemia, Nonstatins, Novel Agents, Statins

Keywords: Myocardial Infarction, Stroke, Follow-Up Studies, San Francisco, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiovascular Diseases, Risk Factors, United States


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