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Statin efficacy in primary CVD prevention might diminish with patient age

Nature Reviews Cardiology volume 16, page 200 (2019)Cite this article

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Statin therapy significantly reduces major vascular events irrespective of age, but less direct evidence is available on the benefit of statins for the primary prevention of cardiovascular disease (CVD) in people aged >75 years. These observations come from a meta-analysis performed by the Cholesterol Treatment Trialists’ Collaboration.

The meta-analysis included 28 randomized, controlled trials on statins involving a total of 186,854 participants, of whom 8% were aged >75 years at randomization. For each 1 mmol/l reduction in LDL-cholesterol level, statins reduced the overall risk of major vascular events by 21% and vascular death by 12%. The proportional reduction in major vascular events was slightly smaller with increasing age, but the trend was not significant. Smaller proportional reductions in vascular death with age were also observed (Ptrend = 0.004), but the trend did not persist after exclusion of four trials on patients with heart failure or who were receiving renal dialysis, in whom statin therapy has little or no benefit. The proportional reductions in major coronary events diminished with age (Ptrend = 0.009) and persisted after exclusion of the heart failure and dialysis trials.

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References

Original article

  • Cholesterol Treatment Trialists’ Collaboration. Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. Lancet 393, 407–415 (2019)

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  1. Nature Reviews Cardiology http://www.nature.com/nrcardio/

    Irene Fernández-Ruiz

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  1. Irene Fernández-Ruiz
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Correspondence to Irene Fernández-Ruiz.

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Fernández-Ruiz, I. Statin efficacy in primary CVD prevention might diminish with patient age. Nat Rev Cardiol 16, 200 (2019). https://doi.org/10.1038/s41569-019-0171-8

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  • DOI: https://doi.org/10.1038/s41569-019-0171-8

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