When to consider post-MI statins in older patients

  • Lefeber GJ & al.
  • J Am Geriatr Soc
  • 24 Oct 2019

  • International Clinical Digest
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Takeaway

  • In patients aged 80 years or more who have had a first myocardial infarction (MI), statins may be appropriate if their 2-year mortality risk is low.

Why this matters

  • Observational data suggest that statins in this older age group offer limited benefits following a first MI, but the study designs have limited the scope of the findings.

Key results

  • Statins for 2 years were tied to reduced risk for composite of recurrent MI, stroke, and cardiovascular mortality: aHR, 0.81 (95% CI, 0.66-0.99).
  • All-cause mortality risk was also decreased in this group: aHR, 0.84 (95% CI, 0.73-0.97).
  • To prevent the composite outcome in 1 patient during the 4.5 years of median follow-up, 59 patients had to be treated.
  • To prevent a death, 39 patients had to be treated.
  • Correcting for deaths in the first 2 years of this period raised both the values.

Study design

  • Retrospective cohort study, 9020 patients, 3900 older than 80 years.
  • 2 years of statin prescriptions were compared with no statin or less than 2 years of statins.
  • Funding: None.

Limitations

  • Retrospective.
  • Unmeasured confounding is likely.
  • Not known if the patients took the prescribed statins.