Key result
Statin discontinuation in adults ≥80 years is not linked to increased major cardiovascular events.
Why the study?
The benefit of continuing statins for primary prevention in older adults aged 80 years or older was uncertain due to lack of randomized controlled trial evidence.
Does statin discontinuation increase the risk of major cardiovascular events in older adults treated for primary prevention?
Cohort (n=1,916,746)
Yes
Does statin discontinuation increase the risk of major cardiovascular events in older adults treated for primary prevention?
Effect estimate: absolute risk difference -0.5% (95% CI -0.7 to -0.3)
Absolute Event Rate: 3.3% vs 3.7%
Absolute Risk Reduction: 0.5%
Discontinuing statin therapy in individuals aged 80 years or older without a history of cardiovascular disease does not increase the risk of major cardiovascular events, supporting the safety of deprescribing in this population.
Statin discontinuation was associated with modestly lower major CV event risk in adults ≥80 on primary prevention; leaves open confounding vs causal effect, needing RCTs.
Introduction: In older adults, the benefit of continuing statins for primary prevention has been called into question.In the absence of evidence from randomized controlled trials, our objective was to estimate the causal effect of statin discontinuation on the risk of cardiovascular events in older adults treated in primary prevention using routinely collected data. Materials and Methods:We emulated a sequence of 12 consecutive target trials using the French National Health Data System (SNDS).Individuals aged ≥ 80 years who were receiving chronic statin treatment and who had no history of atherosclerotic cardiovascular disease, cancer or cognitive disorders were included if they were not hospitalized, institutionalized or receiving palliative care at the time of cohort entry.Each cohort compared statin discontinuation (no statin dispensed during the baseline month of each emulated trial) to statin continuation (at least one statin dispensed during the baseline month).The outcome of interest was the occurrence of a major cardiovascular outcome (acute coronary syndrome, stroke or coronary revascularization) within 2 years.Inverse probability weighting was used to adjust estimates for both confounding and informative censoring.In sensitivity analyses, the intervention was defined as statin discontinuation of at least 3 months.Results: Among 1 916 746 eligible person-trials (median age 84 years; 68% women), 535 813 discontinued statins.The 2-year risk of major cardiovascular outcome was 3.3% (95% confidence interval: 3.1; 3.4) under statin discontinuation and 3.7% under statin continuation (3.7; 3.8), with an absolute risk difference of -0.5% (-0.7; -0.3).Under statin discontinuation for at least 3 months, the absolute risk difference for was 0.0% (-0.2; 0.2).Discussion/Conclusion: In this nationwide study of individuals aged 80 years or older without a history of cardiovascular disease, our findings suggest that discontinuation of statins prescribed for primary prevention does not increase the risk of major cardiovascular events.
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A 2026 study conducted a cohort in Primary cardiovascular prevention (n=1,916,746). Statin discontinuation vs. Statin continuation was evaluated on Major cardiovascular outcome (acute coronary syndrome, stroke or coronary revascularization) within 2 years (absolute risk difference -0.5%, 95% CI -0.7 to -0.3). Statin discontinuation in adults ≥80 years for primary prevention did not increase the 2-year risk of major cardiovascular events compared to continuation (3.3% vs 3.7%; ARD -0.5%).
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