Some older patients benefit from statin therapy
Clinical Question
In elderly patients with heart disease and elevated cholesterol, does treatment with a statin decrease mortality or cardiovascular events?
Bottom Line
Treating 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)
Reference
Afilalo 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 Design
Meta-analysis (randomized controlled trials)
Funding
Unknown/not stated
Setting
Outpatient (any)
Synopsis
The 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).
Citation
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 October 3, 2024.
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 2024 October 03]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426172/all/Some_older_patients_benefit_from_statin_therapy.
* Article titles in AMA citation format should be in sentence-case
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 -