Friday, August 30, 2013

Statins may reduce MI stroke incidence in elderly with no history of CVD

But did they consider this?
higher cholesterol levels may predict longevity, rather than mortality, in the elderly. 

I'm sure your doctor can resolve the conundrum.
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http://www.healio.com/cardiology/stroke/news/online/%7B356a1f47-6797-424c-a4f7-c9f7961d0cdf%7D/statins-may-reduce-mi-stroke-incidence-in-elderly-with-no-history-of-cvd
Results of a new meta-analysis that assessed statin use in elderly patients with no history of CVD indicate a reduced risk for MI and stroke, but no treatment effect on all-cause mortality, CV mortality or new cancer onset.
The meta-analysis included results from eight randomized, placebo-controlled trials of 24,674 participants (57.3% men; mean age, 73 years; mean follow-up, 3.5 years). All studies compared statins vs. placebo and reported outcomes of participants aged at least 65 years who had no history of CVD. Two studies focused on elderly individuals, while the other six had subgroups of elderly individuals. Outcomes of interest were all-cause mortality, CV mortality, MI, stroke and onset of new cancer.
MI occurred in 2.7% of participants assigned statins vs. 3.9% assigned placebo, for a 39.4% difference in risk (RR=0.606; 95% CI, 0.434-0.847). Stroke occurred in 2.1% of those assigned statins vs. 2.8% assigned placebo, for a 23.8% difference in risk (RR=0.762; 95% CI, 0.626-0.926), according to the study findings.
However, the analysis yielded little difference in risk for all-cause mortality (RR=0.941; 95% CI, 0.856-1.035), CV mortality (RR=0.907; 95% CI, 0.686-1.199) or risk for new onset of cancer (RR=0.989; 95% CI, 0.851-1.151) among participants assigned statins vs. those assigned placebo. The incidence of new cancer onset was 5.4% for both statin-treated and placebo-treated patients.
The researchers found no evidence of publication bias or evidence that effect modifiers such as sex, diabetes and hypertension affected the meta-analysis.
“The findings of the present meta-analysis provide evidence for treatment of subjects at high CVD risk and older than 65 years, and may be relevant for upgrading the level of recommendation for treatment in this age group in future guidelines,” Gianluigi Savarese, MD, of Federico II University in Naples, Italy, and colleagues concluded.

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