Some older patients benefit from statin therapy
Clinical QuestionIn elderly patients with heart disease and elevated cholesterol, does treatment with a statin decrease mortality or cardiovascular events?
Bottom LineTreating 28 elderly patients with coronary heart disease (CHD) for 5 years will prevent 1 of them from dying during that period. For every 38 people treated for 5 years, 1 nonfatal myocardial infarction will be prevented; for every 58 patients treated for 5 years, 1 stroke will be prevented. (LOE = 1a)
ReferenceAfilalo J, Duque G, Steele R, Jukema JW, de Craen AJ, Eisenberg MJ. Statins for secondary prevention in elderly patients. J Am Coll Cardiol 2008;51(1):37-45. [PMID:18174034]
Study DesignMeta-analysis (randomized controlled trials)
SynopsisThe researchers carrying out this meta-analysis searched 5 databases, including the Cochrane Central Register, as well as abstracts from cardiology conferences and reference lists of retrieved articles, and contacted authors for additional data. They identified 9 studies that compared a statin with placebo in a total of 19,569 elderly patients with pre-existing CHD. Data from the studies were independently abstracted by 2 investigators. Over an average of 4.9 years of follow-up, the rates of death due to any cause were 18.8% in placebo-treated patients and 15.6% in statin-treated patients (relative risk = 0.78; 95% CI, 0.65 - 0.89). This difference translates into 1 death prevented for every 28 patients treated for 5 years (number needed to treat (NNT) = 28; 5 - 56). Nonfatal myocardial infarction occurred in 10.5% of patients receiving placebo and 8.01% of patients receiving a statin (NNT = 38; 16 - 118). The stroke rate was also decreased, with an NNT of 58 (27 - 177).
Barry, Henry, et al., editors. "Some Older Patients Benefit From Statin Therapy." EE+ POEM Archive, John Wiley & Sons, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426172/all/Some_older_patients_benefit_from_statin_therapy.
Some older patients benefit from statin therapy. In: Barry HH, Ebell MHM, Shaughnessy AFA, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2019. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426172/all/Some_older_patients_benefit_from_statin_therapy. Accessed May 28, 2023.
Some older patients benefit from statin therapy. (2019). In Barry, H., Ebell, M. H., Shaughnessy, A. F., & Slawson, D. C. (Eds.), EE+ POEM Archive. John Wiley & Sons. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426172/all/Some_older_patients_benefit_from_statin_therapy
Some Older Patients Benefit From Statin Therapy [Internet]. In: Barry HH, Ebell MHM, Shaughnessy AFA, Slawson DCD, editors. EE+ POEM Archive. John Wiley & Sons; 2019. [cited 2023 May 28]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426172/all/Some_older_patients_benefit_from_statin_therapy.
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TY - ELEC T1 - Some older patients benefit from statin therapy ID - 426172 ED - Barry,Henry, ED - Ebell,Mark H, ED - Shaughnessy,Allen F, ED - Slawson,David C, BT - EE+ POEM Archive UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426172/all/Some_older_patients_benefit_from_statin_therapy PB - John Wiley & Sons DB - Evidence Central DP - Unbound Medicine ER -