Mortality associated with stopping statins in the oldest-old - with and without ischemic heart disease

被引:4
|
作者
Ioffe, Marina [1 ]
Kremer, Anjelika [1 ]
Nachimov, Irena [2 ]
Swartzon, Michael [3 ]
Justo, Dan [1 ,4 ]
机构
[1] Sheba Med Ctr, Geriatr Div, IL-5265601 Tel Hashomer, Israel
[2] Dorot Geriatr Ctr, Netanya, Israel
[3] Florida Int Univ, Miami, FL 33199 USA
[4] Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel
关键词
ischemic heart disease; mortality; older adults; statins; THERAPY; ROSUVASTATIN; POLYPHARMACY;
D O I
10.1097/MD.0000000000026966
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The association between stopping statins and 1-year mortality in the general population of the oldest-old - with or without ischemic heart disease (IHD) - has been studied herein for the first time. This was a retrospective study. Included were all consecutive patients (n = 369) aged 80 years or more (mean age 87.8 years) hospitalized in a single Geriatrics department during 1 year. The study group included 140 patients in whom statins were stopped upon admission (statin stoppers). The control group included 229 patients who did not use statins in the first place (statin non-users). All-cause 1-year mortality rates were studied in both groups following propensity score matching and in IHD patients separately. Overall, 110 (29.8%) patients died during the year following admission: 38 (27.1%) statin stoppers and 72 (31.4%) statin non-users (P = .498). Cox regression analysis showed no association between stopping statins and 1-year mortality in the crude analysis (hazard ratio [HR] 0.976, 95% confidence interval [CI] 0.651-1.463, P = .907) and following propensity score matching (HR 1.067, 95%CI 0.674-1.689, P = .782). Among 108 IHD patients, 38 (35.2%) patients died during the year following admission: 18 (27.7%) statin stoppers and 20 (46.5%) statin non-users (P = .059). Cox regression analysis showed a nearly significant association between stopping statins (rather than not using statins) in IHD patients and lower 1-year mortality (HR 0.524, 95%CI 0.259-1.060, P = .072). Hence, stopping statins in the general population of the oldest-old - with or without IHD - is possibly safe. Future studies including the oldest-old statin continuers are warranted to confirm this observation.
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页数:6
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