Author + information
- Received October 20, 2009
- Revision received January 20, 2010
- Accepted January 25, 2010
- Published online March 30, 2010.
- Klas Gränsbo, MD⁎,
- Olle Melander, MD⁎,
- Lars Wallentin, MD†,
- Johan Lindbäck, PhD†,
- Ulf Stenestrand, MD‡,
- Jörg Carlsson, MD§ and
- Jan Nilsson, MD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Jan Nilsson, CRC Lund University, Building 91:12, Malmö University Hospital, Entrance 72, SE-205 02 Malmö, Sweden
Objectives The purpose of this study was to determine whether statin treatment is effective and safe in very elderly (80 years and older) acute myocardial infarction (AMI) patients.
Background Elderly individuals constitute an increasing percentage of patients admitted to hospitals for AMI. Despite that these patients have a higher mortality risk, the application of evidence-based medicine remains much lower than for younger patients.
Methods We included all patients 80 years and older who were admitted with the diagnosis of AMI in the Register of Information and Knowledge About Swedish Heart Intensive Care Admissions between 1999 and 2003 (n = 21,410). Of these, complete covariate and follow-up data were available for 14,907 patients (study population A). To limit the bias related comorbidity on statin therapy, we also performed analyses excluding patients who died within 14 days of the acute event (study population B) and all patients who died within 365 days (study population C). A propensity score was used to adjust for initial differences between treatment groups.
Results All-cause mortality was significantly lower in patients receiving statin treatment at discharge in study population A (relative risk: 0.55, 95% confidence interval: 0.51 to 0.59), in study population B (relative risk: 0.65; 95% confidence interval: 0.60 to 0.71), and in study population C (relative risk: 0.66; 95% confidence interval: 0.59 to 0.76). Similar observations were made for cardiovascular mortality as well as for AMI mortality. There was no increase in cancer mortality in statin-treated patients.
Conclusions Statin treatment is associated with lower cardiovascular mortality in very elderly post-infarction patients without increasing the risk of the development of cancer.
Funding from the Swedish Medical Research Council, the Swedish Heart-Lung Foundation, Söderberg Foundation, Knut and Alice Wallenberg Foundation, Lars Hierta Memorial Foundation, Malmö University Hospital Foundation, Albert Påhlsson Foundation, and the Lundström Foundation.
- Received October 20, 2009.
- Revision received January 20, 2010.
- Accepted January 25, 2010.
- American College of Cardiology Foundation