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Evidence summaries

Statins for Secondary Prevention in Elderly Patients

Statins reduce all-cause and cardiovascular mortality and vascular events in elderly patients with coronary heart disease. Level of evidence: "A"

A systematic review 1 including 9 studies with a total of 19 569 subjects was abstracted in DARE. Coronary heart disease (CHD) patients aged 65 years or older were included. The statins used were simvastatin (20-40mg), pravastatin (40mg) or fluvastatin (80mg). All trials were double-blind, and all but one used an intention-to-treat analysis. Seven trials achieved a 95% follow-up rate. Statin use was associated with a reduction in all-cause mortality (RR 0.78, 95% CI 0.65 to 0.89) with NNT of 28. Statins reduced CHD mortality (RR 0.70, 95% CI 0.53 to 0.83) with NNT of 34. Non-fatal myocardial infarction was reduced in the statin group (RR 0.74, 95% CI 0.60 to 0.89) with NNT of 38. Need for revascularisation was reduced (RR 0.70, 95% CI 0.53 to 0.83) with NNT of 24. Stroke incidence was reduced (RR 0.75, 95% CI 0.56 to 0.94) with NNT of 58.

References

  • Afilalo J, Duque G, Steele R, Jukema JW, de Craen AJ, Eisenberg MJ. Statins for secondary prevention in elderly patients: a hierarchical bayesian meta-analysis. J Am Coll Cardiol 2008 Jan 1;51(1):37-45. [PubMed][DARE]

Primary/Secondary Keywords