Key result
Statin use for primary prevention linked to ~46% lower all-cause mortality in older adults.
Why the study?
Evidence on statin use for primary prevention of cardiovascular disease in older people needed to be extended and updated to provide further guidance for clinical practice.
Does statin use reduce all-cause mortality, CVD mortality, CHD/MI, stroke, and total CV events in older people (≥65 years) for primary prevention?
Meta-Analysis (n=1,627,434)
Does statin use reduce all-cause mortality, CVD mortality, CHD/MI, stroke, and total CV events in older people (≥65 years) for primary prevention?
Effect estimate: HR 0.54 (95% CI 0.46-0.63)
p-value: p=<0.01
Statin use for primary prevention in older adults (≥65 years) is associated with significant reductions in all-cause mortality, CVD mortality, stroke, and total CV events, supporting their broader use in this population.
May support statin consideration for primary prevention in adults ≥65 years; leaves open confirmation in dedicated RCTs.
Background: Evidence on statin use for primary prevention of cardiovascular disease (CVD) in older people needs to be extended and updated, aiming to provide further guidance for clinical practice. Methods: PubMed, EMBASE, Cochrane Library and Web of Science were searched for eligible observational studies comparing statin use vs. no-statin use for primary prevention of CVD in older people (age ≥65 years). The primary outcomes were all-cause mortality, CVD mortality, coronary heart disease (CHD)/myocardial infraction (MI), stroke and total CV events. Risk estimates of each relevant outcome were synthesized as a hazard ratio (HR) with 95% confidence interval (95% CI) using in the random-effects model. Results: Twelve eligible observational studies (n = 1,627,434) were enrolled. The pooled results suggested that statin use was associated with a significantly decreased risk of all-cause mortality (HR: 0.54, 95% CI: 0.46–0.63), CVD mortality (HR: 0.51, 95% CI: 0.39–0.65), CHD/MI (HR: 0.83, 95% CI: 0.69–1.00), stroke (HR: 0.79, 95% CI: 0.68–0.92) and total CV events (HR: 0.75, 95% CI: 0.66–0.85). The association in all-cause mortality still remained obvious at higher ages (≥70 years old, HR: 0.56, 95% CI: 0.44–0.71; ≥75 years old, HR: 0.70, 95% CI: 0.60–0.80; ≥85 years old, HR: 0.85, 95% CI: 0.74–0.97), ≥20% (HR: 0.47, 95% CI: 0.35–0.62) and <20% diabetic populations (HR: 0.50, 95% CI: 0.40–0.64), and ≥50% (HR: 0.68, 95% CI: 0.59–0.79) and <50% hypertensive populations (HR: 0.38, 95% CI: 0.16–0.88). Conclusions: Statin use was related to a 46%, 49%, 17%, 21% and 25% risk reduction on all-cause mortality, CVD mortality, CHD/MI, stroke and total CV events in older patients, respectively. The significant association was also addressed in older patients and ≥75 years old individuals for CVD primary prevention.
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Huang et al. (2022) conducted a meta-analysis in Cardiovascular disease (primary prevention) (n=1,627,434). Statin vs. No statin use was evaluated on All-cause mortality (HR 0.54, 95% CI 0.46-0.63, p=<0.01). Statin use was associated with a 46% reduced risk of all-cause mortality (HR 0.54) compared to no statin use for primary prevention of cardiovascular disease in adults aged 65 years and older.
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