Association of Statin Use With All-Cause and Cardiovascular Mortality in US Veterans 75 Years and Older
Retrospective cohort study for primary prevention (n=326,981) found less deaths in statin users vs non-users (78.7 vs 98.2 deaths/1000 person-years, p<0.05), as well as fewer CV deaths (22.6 vs 25.7/1000 person-years, p<0.05). Authors highlight RCTs are needed.
Source:
Journal of the American Medical Association
SPS commentary:
A related editorial discusses this research, stating that because the involvement of older patients in statin trials has been low, much of the current understanding of the potential safety and efficacy of statins in this population is derived from underpowered subgroup analyses and limited observational studies. This array of evidence has produced conflicting results, ranging from reports of marked benefit on clinical atherosclerotic outcomes to the suggestion of an increase in all-cause mortality. This new evidence provides some new insight, however, RCTs are needed. It concludes that because patients older than 75 years represent one of the fastest-growing population subgroups in health care systems, there is a major need to provide an evidence base that informs use of therapies that are both safe and efficacious, in a cost-effective manner. To achieve this goal, additional rigorous studies in these patients are needed to determine the most optimal approach to delivering health care to the oldest members of society.