There is limited evidence on statin risk and effectiveness for patients aged 80+. We estimated risk of recurrent myocardial infarction, muscle-related and other adverse events, and statin-related incremental costs in "real-world" older patients treated with statins versus no statins.This article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text from the publisher's site.Published (Open Access

Alessandro Ble

David Melzer

Golomb

Jan Zirk-Sadowski

Jane A. Masoli

Joao Delgado

Kirsty Bowman

McGuinness

Peter M. Hughes

Ruben E. Mujica Mota

Taylor

Tunstall-Pedoe

William E. Henley

The Journals of Gerontology Series A

PubMed

Crossref

Safety and Effectiveness of Statins for Prevention of Recurrent Myocardial Infarction in 12 156 Typical Older Patients: A Quasi-Experimental Study

There is limited evidence on statin risk and effectiveness for patients aged 80+. We estimated risk of recurrent myocardial infarction, muscle-related and other adverse events, and statin-related incremental costs in "real-world" older patients treated with statins versus no statins.Published (Open Access)This article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text from the publisher's site

Ble, A.

Hughes, P. M.

Delgado, J.

Masoli, Jane A.

Bowman, K.

Zirk-Sadowski, J.

Mujica Mota, R. E.

Henley, W. E.

Melzer, David

Royal Devon and Exeter Research Repository

Safety and Effectiveness of Statins for Prevention of Recurrent Myocardial Infarction in 12 156 Typical Older Patients: A Quasi-Experimental Study.

RD&E Research Repository

BACKGROUND: There is limited evidence on statin risk and effectiveness for patients aged 80+. We estimated risk of recurrent myocardial infarction, muscle-related and other adverse events, and statin-related incremental costs in "real-world" older patients treated with statins versus no statins. METHODS: We used primary care electronic medical records from the UK Clinical Practice Research Datalink. Subhazard ratios (competing risk of death) for myocardial infarction recurrence (primary end point), falls, fractures, ischemic stroke, and dementia, and hazard ratios (Cox) for all-cause mortality were used to compare older (60+) statin users and 1:1 propensity-score-matched controls (n = 12,156). Participants were followed-up for 10 years. RESULTS: Mean age was 76.5±9.2 years; 45.5% were women. Statins were associated with near significant reduction in myocardial infarction recurrence (subhazard ratio = 0.84, 0.69-1.02, p = .073), with protective effect in the 60-79 age group (0.73, 0.57-0.94) but a nonsignificant result in the 80+ group (1.06, 0.78-1.44; age interaction p = .094). No significant associations were found for stroke or dementia. Data suggest an increased risk of falls (1.36, 1.17-1.60) and fractures (1.33, 1.04-1.69) in the first 2 years of treatment, particularly in the 80+ group. Treatment was associated with lower all-cause mortality. Statin use was associated with health care cost savings in the 60-79 group but higher costs in the 80+ group. CONCLUSIONS: Estimates of statin effectiveness for the prevention of recurrent myocardial infarction in patients aged 60-79 years were similar to trial results, but more evidence is needed in the older group. There may be an excess of falls and fractures in very old patients, which deserves further investigation.This research is funded by the UK National Institute for Health Research (NIHR) School for
Public Health Research (SPHR). SPHR is a partnership between the Universities of Sheffield,
Bristol, Cambridge, Exeter, UCL; The London School for Hygiene and Tropical Medicine;
the LiLaC (Universities of Liverpool and Lancaster and Fuse)

Ble, A

Hughes, PM

Delgado, J

Masoli, JA

Bowman, K

Zirk-Sadowski, J

Mujica Mota, RE

Henley, WE

Melzer, D

Open Research Exeter

Background:

There is limited evidence on statin risk and effectiveness for patients aged 80+. We estimated risk of recurrent myocardial infarction, muscle-related and other adverse events, and statin-related incremental costs in “real-world” older patients treated with statins versus no statins.



Methods:

We used primary care electronic medical records from the UK Clinical Practice Research Datalink. Subhazard ratios (competing risk of death) for myocardial infarction recurrence (primary end point), falls, fractures, ischemic stroke, and dementia, and hazard ratios (Cox) for all-cause mortality were used to compare older (60+) statin users and 1:1 propensity-score-matched controls (n = 12,156). Participants were followed-up for 10 years.



Results:

Mean age was 76.5±9.2 years; 45.5% were women. Statins were associated with near significant reduction in myocardial infarction recurrence (subhazard ratio = 0.84, 0.69–1.02, p = .073), with protective effect in the 60–79 age group (0.73, 0.57–0.94) but a nonsignificant result in the 80+ group (1.06, 0.78–1.44; age interaction p = .094). No significant associations were found for stroke or dementia. Data suggest an increased risk of falls (1.36, 1.17–1.60) and fractures (1.33, 1.04–1.69) in the first 2 years of treatment, particularly in the 80+ group. Treatment was associated with lower all-cause mortality. Statin use was associated with health care cost savings in the 60–79 group but higher costs in the 80+ group.



Conclusions:

Estimates of statin effectiveness for the prevention of recurrent myocardial infarction in patients aged 60–79 years were similar to trial results, but more evidence is needed in the older group. There may be an excess of falls and fractures in very old patients, which deserves further investigation

White Rose Research Online

English

Safety and Effectiveness of Statins for Prevention of Recurrent Myocardial Infarction in 12 156 Typical Older Patients: A Quasi-Experimental Study.

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