Statin risk-reducing effect for major vascular events fades with age

  • Lancet
  • 2 Feb 2019

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Although statins reduce risk for major vascular events in people over age 75 years, in the absence of occlusive vascular disease, evidence is “less direct.”
  • Authors of this meta-analysis say current trials are addressing this gap. 

Why this matters

  • Authors say the findings suggest that 1.0 mmol/L reduction in low-density lipoprotein (LDL) cholesterol could translate into annually preventing major vascular events in:
    • 50 of every 10,000 people aged 63 years and
    • 80 of every 10,000 people aged 78 years. 

Key results

  • For the overall population across studies, risk reduction was 21% with statin therapy:
    • Rate ratio, 0.79 (95% CI, 0.77-0.81).
  • Reductions were seen across all age groups but diminished with age.
  • Statin or therapy intensification was linked to 24% risk reduction for major coronary events for each 1.0 mmol/L reduction in LDL.
  • With age, this effect decreased (Ptrend=.009).
  • A similar pattern was seen for coronary revascularization risk.
  • Statins did not affect risk for nonvascular or cancer mortality or cancer incidence.

Study design

  • Meta-analysis, 28 trials (n=186,854).
  • Outcomes: effects on risk for major vascular events, mortality, cancer.
  • Funding: Australian National Health and Medical Research Council, others.

Limitations

  • Those of included trials; limited direct evidence for oldest age group.

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