AHA 2020 | Statins: Confirmed Benefits for the Elderly

Elderly patients (>70) with high cholesterol levels have been systematically excluded from randomized studies on statins, despite their higher risk of cardiovascular events. Presented at AHA 2020 Scientific Sessions and published simultaneously in the Lancet, along comes this primary prevention study including patients between 70 and 100 years of age. 

The use of therapies to reduce cholesterol in the elderly population (statins, ezetimibe and PCSK9 inhibitors) reduces cardiovascular events rate as effectively as in the younger population.

The risk is cut down by 26% for every 39 mg/dl reduction in LDL regardless the age (p=0.37 for interaction).

Baseline events rate in the elderly is higher and yet the relative risk rate of events with cholesterol reduction therapies is similar to that of the younger population. Therefore, the impact of higher cholesterol on cardiovascular events in the elderly, in absolute terms, is significant. 

Many physicians share the idea that if a patient over 70 has not been on any anti-cholesterol treatment, and has not had any cardiovascular events, it’s because they are extremely healthy; they think adding statins as primary prevention to this population will only increase costs and eventually adverse effects brought by these drugs. However, we should forget the claim that states the benefit of statins in the elderly population is the same as their benefit for the younger population. 


Read also: In-Stent Restenosis Treatment: Meta-Analysis of 10 Randomized Studies.


ACC/AHA guidelines should be compared against these new data. The study suggests a 75-year-old threshold, or younger, for intense anti-cholesterol therapy and flexible recommendations for the elderly. 

estatinas-en-anosos

Original Title: Elevated LDL cholesterol and increased risk of myocardial infarction and atherosclerotic cardiovascular disease in individuals aged 70-100 years: a contemporary primary prevention cohort.

Reference: Mortensen MB et al. Lancet. 2020; Epub ahead of print y presentado simultáneamente en las sesiones científicas del AHA 2020.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

Patients at High Risk of Bleeding After Coronary Angioplasty: Are Risk Assessment Tools ARC-HBR and PRECISE-DAPT Useful?

Patients undergoing coronary stenting typically receive dual antiplatelet therapy (DAPT) for 6 to 12 months, consisting of a P2Y12 receptor inhibitor and aspirin. While DAPT...

ACC-2025 Congress Second Day Key Studies

BHF PROTECT-TAVI (Kharbanda RK, Kennedy J, Dodd M, et al.)The largest randomized  trial carried out across 33 UK centers between 2020 and 2024, assessing...

ACC 2025 | API-CAT: Reduced vs. Full Dose Extended Anticoagulation in Patients with Cancer Related VTE

The risk of cancer related recurrent venous thromboembolism (VTE) will drop over time, while bleeding risk will persist. At present, it is recommended we...

STRIDE: Semaglutide in Patients with Peripheral Arterial Disease and Type II Diabetes

Peripheral arterial disease (PAD) is a severe complication in patients with type II diabetes, primarily affecting peripheral vessels, especially below-the-knee (BTK) arteries. This condition...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TAVR in Small Annuli: What Valve Should We Use?

One of the major challenges of severe aortic stenosis are patients with small aortic annuli, defined as ≤430 mm² aortic valve area. This condition...

Patients at High Risk of Bleeding After Coronary Angioplasty: Are Risk Assessment Tools ARC-HBR and PRECISE-DAPT Useful?

Patients undergoing coronary stenting typically receive dual antiplatelet therapy (DAPT) for 6 to 12 months, consisting of a P2Y12 receptor inhibitor and aspirin. While DAPT...

ACC 2025 | WARRIOR: Ischemia in Women with Non-Obstructive Coronary Artery Disease

Approximately half of all women with symptomatic ischemia who undergo coronary angiography are found to have non-obstructive coronary artery disease ((ischemia and non-obstructive coronary...