Statins may reduce CV events in older patients with stroke
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Older patients with ischemic stroke who took statins for 2 years after discharge experienced fewer CV events after hospital discharge compared with those who took them for less than 2 years or not at all, researchers reported in Stroke.
Although statins are frequently initiated in patients aged 80 years and older after an ischemic stroke, evidence of their efficacy in CVD prevention for this population is sparse, so a new analysis was needed, the researchers wrote.
Geert J. Lefeber, MD, from the department of geriatrics, University Medical Center Utrecht, and the division of pharmacoepidemiology and clinical pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands, and colleagues conducted a retrospective cohort study of 5,910 patients aged 65 years and older hospitalized for a first ischemic stroke from 1999 to 2016 who did not have statin prescriptions in the year before hospitalization.
The primary outcome was a composite of recurrent stroke, MI and CV mortality at 2 years. The primary analysis was for patients aged 80 years or older, but the researchers also analyzed patients aged 65 to 80 years to compare their results with current evidence on statin efficacy.
Among the 3,157 patients aged 80 years and older, compared with those who had a statin prescription of less than 2 years or none at all, those who had a statin prescription for 2 years had lower risk for the primary endpoint (adjusted HR = 0.8; 95% CI, 0.62-1.02) and all-cause mortality (aHR = 0.67; 95% CI, 0.57-0.8).
After correction for the mortality of 23.9% of the patients during the first 2 years, the number needed to treat to prevent one event was 64 for the primary outcome and 19 for all-cause mortality during a median follow-up of 3.9 years.
“To be able to decide whether benefits outweigh harm and which is the most appropriate dose and type of statin, more research is deemed necessary in the oldest old,” Lefeber and colleagues wrote.
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