Premium
Effect of Statin Therapy on Mortality in Older Adults Hospitalized with Coronary Artery Disease: A Propensity‐Adjusted Analysis
Author(s) -
Rothschild Daniel P.,
Novak Eric,
Rich Michael W.
Publication year - 2016
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14207
Subject(s) - medicine , hazard ratio , coronary artery disease , myocardial infarction , statin , retrospective cohort study , propensity score matching , angina , unstable angina , population , confidence interval , cohort , cohort study , medical prescription , physical therapy , environmental health , pharmacology
Objectives To examine the effect of statins on long‐term mortality in older adults hospitalized with coronary artery disease ( CAD ). Design Retrospective analysis. Setting University teaching hospital. Participants Individuals aged 80 and older (mean aged 85.2, 56% female) hospitalized from January 2006 to December 2010 with acute myocardial infarction ( AMI ), unstable angina pectoris, or chronic CAD and discharged alive (N = 1,262). Participants were divided into those who did (n = 913) and did not (n = 349) receive a discharge prescription for a statin. Measurements All‐cause mortality over a median follow‐up of 3.1 years. Results Participants treated with statins were more likely to be male, to have a primary diagnosis of AMI , to have traditional cardiovascular risk factors, and to receive other standard cardiovascular medications in addition to statins. In unadjusted analysis, statin therapy was associated with lower mortality (hazard ratio ( HR ) = 0.83, 95% confidence interval ( CI ) = 0.71–0.96). After adjustment for baseline differences between groups and propensity for receiving statin therapy, the effect of statins on mortality was no longer significant ( HR = 0.88, 95% CI = 0.74–1.05). The association between statins and mortality was similar in participants aged 80 to 84 and those aged 85 and older. Conclusion In this cohort of older adults hospitalized with CAD , statin therapy had no significant effect on long‐term survival after adjustment for between‐group differences. These findings, although preliminary, call into question the benefit of statin therapy for secondary prevention in a real‐world population of adults aged 80 and older and underscore the need for shared decision‐making when prescribing statins in this age group.