intensity of statin therapy and mortality.
In the cohort, 29.6% of patients were prescribed a high-intensity statin, 45.6% a moderate-intensity statin, 6.7% a low-intensity statin and 18.2% no statins.
After mean follow-up of 492 days, 4% of those prescribed a high-intensity statin died vs. 4.8% of those receiving a moderate-intensity statin, 5.7% of those receiving a low-intensity statin and 6.6% of those receiving no statins (P < .001), Fatima Rodriguez, MD, MPH, from the division of cardiovascular medicine and the Cardiovascular Institute, Stanford University, and colleagues wrote.
When Rodriguez and colleagues adjusted for propensity to receive high-intensity statin therapy, those who received high-intensity statins remained at lower risk for death vs. those who received moderate-intensity statins (adjusted HR = 0.91; 95% CI, 0.88-0.93).
Among patients who had received their first statin prescription within the prior 6 months, the effect of intensity on survival was slightly less (adjusted HR = 0.93; 95% CI, 0.85-1.01), according to the researchers.
The effect of statin intensity on survival was similar in those aged 75 years or younger (HR = 0.9; 95% CI, 0.88-0.93) and in those aged 76 to 84 years (HR = 0.91; 95% CI, 0.87-0.95).
Although the relationship between statin intensity and mortality was not seen in randomized controlled trials, “it is ... possible that this study detected a signal not found in the [randomized controlled trials] because of its very large sample size relative to [randomized controlled trials] and because it involves a broader population, including patients older than 75 years,” Robert O. Bonow, MD, MS, editor of JAMA Cardiology, and Clyde W. Yancy, MD, MSc, deputy editor of JAMA Cardiology, wrote in an editor’s note.
Disclosure: The researchers, Bonow and Yancy report no relevant financial disclosures.