Greater use of statins could extend lives of elderly heart disease patients
Treatment of older heart disease patients with statins reduces their death rate over five years by more than 20%, according to a research analysis involving nearly 20,000 patients.
“Statins continue to be underutilised in elderly patients because evidence has not consistently shown that they reduce mortality,” Dr Mark J Eisenberg, at McGill University in Montreal, and co-authors wrote in summarising their findings for the Journal of the American College of Cardiology. The fact that the elderly have been under-represented in clinical trials appears to be part of the problem, they said.
Researchers conducted a meta-analysis of nine randomised, placebo-controlled trials in which a total of 19,569 patients between the ages of 65 and 82 were tracked for an average of five years.
They found that the relative risk of death from all causes was reduced by 22%. However, death from coronary disease fell even further, with a relative risk reduction of 30%, and the relative risks of nonfatal myocardial infarct (MI), the need for revascularisation, and the incidence of stroke decreased by 25% to 30%.
Statins are a class of drugs primarily used to lower cholesterol. In an editorial accompanying the research findings, Dr George A Diamond and Dr Sanjay Kaul, cardiologists at UCLA, said statins ha proven “remarkably safe” and cost-effective in the elderly.
Still, statin use has stagnated at 40% to 60% in elderly patients with heart disease, while the use of angioplasty “continues to increase despite the lack of equivalent evidence of outcomes benefit”.
