Author + information
- Received May 22, 2013
- Revision received July 3, 2013
- Accepted July 13, 2013
- Published online December 3, 2013.
- Gianluigi Savarese, MD∗,
- Antonio M. Gotto Jr., MD, PhD†,
- Stefania Paolillo, MD∗,
- Carmen D'Amore, MD∗,
- Teresa Losco, MD∗,
- Francesca Musella, MD∗,
- Oriana Scala, MD∗,
- Caterina Marciano, MD∗,
- Donatella Ruggiero, MD∗,
- Fabio Marsico, MD∗,
- Giuseppe De Luca, MD, PhD‡,
- Bruno Trimarco, MD, PhD∗ and
- Pasquale Perrone-Filardi, MD, PhD∗∗ ()
- ∗Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
- †Weill Cornell Medical College, New York, New York
- ‡Division of Cardiology, Piemonte Orientale University, Novara, Italy
- ↵∗Reprint requests and correspondence:
Dr. Pasquale Perrone-Filardi, Department of Advanced Biomedical Sciences, Federico II University, Via Pansini, 5-I80131 Naples, Italy.
Objectives The purpose of this paper was to assess whether statins reduce all-cause mortality and cardiovascular (CV) events in elderly people without established CV disease.
Background Because of population aging, prevention of CV disease in the elderly is relevant. In elderly patients with previous CV events, the use of statins is recommended by guidelines, whereas the benefits of these drugs in elderly subjects without previous CV events are still debated.
Methods Randomized trials comparing statins versus placebo and reporting all-cause and CV mortality, myocardial infarction (MI), stroke, and new cancer onset in elderly subjects (age ≥65 years) without established CV disease were included.
Results Eight trials enrolling 24,674 subjects (42.7% females; mean age 73.0 ± 2.9 years; mean follow up 3.5 ± 1.5 years) were included in analyses. Statins, compared with placebo, significantly reduced the risk of MI by 39.4% (relative risk [RR]: 0.606 [95% confidence interval (CI): 0.434 to 0.847]; p = 0.003) and the risk of stroke by 23.8% (RR: 0.762 [95% CI: 0.626 to 0.926]; p = 0.006). In contrast, the risk of all-cause death (RR: 0.941 [95% CI: 0.856 to 1.035]; p = 0.210) and of CV death (RR: 0.907 [95% CI: 0.686 to 1.199]; p = 0.493) were not significantly reduced. New cancer onset did not differ between statin- and placebo-treated subjects (RR: 0.989 [95% CI: 0.851 to 1.151]; p = 0.890).
Conclusions In elderly subjects at high CV risk without established CV disease, statins significantly reduce the incidence of MI and stroke, but do not significantly prolong survival in the short-term.
Dr. Gotto has served on the Board of Directors of Aegerion Pharmaceuticals and Arisaph Pharmaceuticals; has served on the Advisory Board of DuPont and Vetera Capital; and has served as a consultant for AstraZeneca Pharmaceuticals; Janssen, KOWA, Merck, and Roche. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 22, 2013.
- Revision received July 3, 2013.
- Accepted July 13, 2013.
- American College of Cardiology Foundation