Statin use can lower an older patient’s risk of all-cause and cardiovascular mortality, according to a new study of more than 325,000 U.S. veterans.
The research, published in JAMA, focused on individuals 75 years and older, a population often disregarded by many critical trials.
“Statins are a mainstay of atherosclerotic cardiovascular disease (ASCVD) primary prevention, but guidelines remain equivocal on their role for persons 75 years and older, primarily because of a paucity of data,” wrote lead author Ariela R. Orkaby, MD, MPH, VA Boston Healthcare System, and colleagues. “This gap is mostly attributable to lack of enrollment of individuals 75 and older in all major statin trials: Fewer than 2% of 186 854 participants in 28 statin trials were 75 years and older.”
Orkaby’s team used data from both CMS and the U.S. Veterans Health Administration for its study. Patients were treated from 2002 to 2012. Exclusions were made if the patient had a history of MI, transient ischemic attack or stroke, peripheral vascular disease or coronary revascularization.
After a mean follow-up period of 6.8 years, there had been a total of more than 200,000 deaths. Among statin users, there were 78.7 total deaths per 1,000 person-years. Among nonusers, that number was 98.2 total deaths per 1,000 person-years.
In addition, there had been 22.6 and 25.7 cardiovascular deaths per 1,000 person-years among statin users and nonusers, respectively.
“Results remained consistent even at advanced ages and in those with comorbidities, with similar lower risk for mortality observed in statin users 90 years and older or with dementia,” the authors wrote. “In secondary analyses, new statin use was also significantly associated with a lower risk of a composite of ASCVD events.”
The team added that these findings “suggest that statins are effective for prevention of mortality when taken for primary prevention of ASCVD.https://trimedcms.com/node/add/article” However, more research—including randomized clinical trials—is still needed.
A recent study published in the Journal of the American College of Cardiology focused on similar questions; the authors identified an association between baseline statin use and major adverse cardiovascular events among patients 70 years or older.