Abstract 12760: Effects of Statin Therapy by Age in a Meta-Analysis of Individual Patient Data from 174 000 Patients in the Cholesterol Treatment Trialists’ Collaboration Study
Objective: Using individual patient data, we aimed to assess the efficacy and safety of statin therapy according to age.
Methods: We analysed data from 27 randomised controlled trials assessing the effects of either statin vs. control or high dose (more) statin vs. lower dose (less) statin on a series of pre-specified outcomes in age groups ≤60, 60-69 and ≥70 years. Effects of statins on cardiovascular and mortality endpoints were expressed as the hazard ratio (HR, 99% CI for all population subgroups) associated with a 1.0 mmol/L (39mg/dL) reduction of blood LDL-cholesterol.
Results: Of 174099 participants, 62744 (36%) were aged ≤60, 67159 (39%) were aged 60-69 and 44196 (25%) were aged ≥70.
Statin/more therapy significantly reduced major vascular events in each age range, but there was a significant trend showing a lower relative risk reduction as age increased. This trend was similarly seen for reductions in non-fatal MI, cardiovascular death and all-cause mortality, but not for stroke or coronary revascularisation. Numbers needed to treat to prevent a major vascular event for each 1.0 mmol/L LDL-cholesterol reduction with statin therapy were 37 for age≤60, 29 for age 60-69 and 36 for age ≥70 years. No effects of statin/high dose therapy on cancer incidence, cancer mortality or non-vascular mortality were seen in any age group.
Conclusions: Patients in all age groups examined experience significant cardiovascular benefits from statin or high dose statin therapy, including the elderly. The relative efficacy of statin therapy in preventing major vascular events is less as age increases, but since the absolute event risk increases with age, numbers needed to treat to prevent these events are similar across all age groups.
- © 2013 by American Heart Association, Inc.