Thursday, September 23, 2010
statins
Cardiovascular and Cancer Mortality in Very Elderly Post-Myocardial Infarction Patients Receiving Statin Treatment
Melvin Cheitlin
Authors and Disclosures
Posted: 09/16/2010; Faculty of 1000 Medicine © Medicine Reports Ltd.
Other Health Care Provider Rating: 0 stars ( 0 Votes )
Rate This Article:
0 stars
* Print This Print This
* Email This Email this
processing....
Gränsbo K, Melander O, Wallentin L, Lindbäck J, Stenestrand U, Carlsson J, Nilsson J
J Am Coll Cardiol 2010 Mar 30 55(13):1362-9
Commentary from Melvin Cheitlin
Changes Clinical Practice: Statins, at the maximum safe dosage for the particular statin being prescribed, should be used to reduce the cardiovascular mortality of acute myocardial infarction patients aged 80 or over (statins can be prescribed without increasing the incidence of cancer).
There are excellent data for the effectiveness of statins in decreasing mortality in patients with an acute myocardial infarction. However, in many of the studies there were few or no very elderly patients. This study gives evidence of the effectiveness of statin therapy in decreasing mortality in very elderly patients after an acute myocardial infarction. Many physicians are wary of starting statins in very elderly post-infarction patients because of possible side effects, the relatively sparse evidence of effectiveness in this age group, the fear that statins increase the incidence of cancer and (with the expectation that the patient's life-span being very limited) that any long-term benefit from the statins would not be expected. This study should put these fears to rest.
This study addresses a problem with evidence-based therapy in that studies often exclude very old patients. Elderly patients are excluded in these studies because they have a greater number of comorbidities that could obscure the benefit of the studied therapy. In this paper, the evidence shows that statin therapy increases survival after an acute myocardial infarction in patients aged 80 years and older. The follow-up time of a median 296 days, maximum 5 years, showed the total mortality and the cardiovascular mortality to be decreased by 45% and similar reductions occurred in cardiovascular mortality in those patients taking a statin. The mortality outcomes were similar where patients who died within 14 days of the acute event were excluded, as well as all patients who died within the first year after the acute event. This is very good evidence of the effectiveness of statins even in very old patients who have an acute myocardial infarction. For additional background reading, please see refs.[
Melvin Cheitlin
Authors and Disclosures
Posted: 09/16/2010; Faculty of 1000 Medicine © Medicine Reports Ltd.
Other Health Care Provider Rating: 0 stars ( 0 Votes )
Rate This Article:
0 stars
* Print This Print This
* Email This Email this
processing....
Gränsbo K, Melander O, Wallentin L, Lindbäck J, Stenestrand U, Carlsson J, Nilsson J
J Am Coll Cardiol 2010 Mar 30 55(13):1362-9
Commentary from Melvin Cheitlin
Changes Clinical Practice: Statins, at the maximum safe dosage for the particular statin being prescribed, should be used to reduce the cardiovascular mortality of acute myocardial infarction patients aged 80 or over (statins can be prescribed without increasing the incidence of cancer).
There are excellent data for the effectiveness of statins in decreasing mortality in patients with an acute myocardial infarction. However, in many of the studies there were few or no very elderly patients. This study gives evidence of the effectiveness of statin therapy in decreasing mortality in very elderly patients after an acute myocardial infarction. Many physicians are wary of starting statins in very elderly post-infarction patients because of possible side effects, the relatively sparse evidence of effectiveness in this age group, the fear that statins increase the incidence of cancer and (with the expectation that the patient's life-span being very limited) that any long-term benefit from the statins would not be expected. This study should put these fears to rest.
This study addresses a problem with evidence-based therapy in that studies often exclude very old patients. Elderly patients are excluded in these studies because they have a greater number of comorbidities that could obscure the benefit of the studied therapy. In this paper, the evidence shows that statin therapy increases survival after an acute myocardial infarction in patients aged 80 years and older. The follow-up time of a median 296 days, maximum 5 years, showed the total mortality and the cardiovascular mortality to be decreased by 45% and similar reductions occurred in cardiovascular mortality in those patients taking a statin. The mortality outcomes were similar where patients who died within 14 days of the acute event were excluded, as well as all patients who died within the first year after the acute event. This is very good evidence of the effectiveness of statins even in very old patients who have an acute myocardial infarction. For additional background reading, please see refs.[
# posted by roodbont @ 2:58 PM 
