Abstract 14264: The Target Value Of Low Density Lipoprotein Cholesterol And Preventive Effect Of Statins Were Different Between Elderly Patients And Younger Patients
Introduction: With an aging society, elderly patients with cardiac ischemia are increasing. However, there is little information regarding predictors in secondary prevention of Japanese elderly patients.
Hypothesis: We assessed the hypothesis whether the target value of LDL-C and preventive effect of statins were different between elderly patients and younger patients.
Methods: We investigated 294 patients with previous percutaneous coronary intervention who underwent coronary angiography from January 2007 to December 2015 to examine recurrent cardiac ischemia beyond the period of early restenosis. Subjects were classified into two groups; over 75 years old (Elderly: n=137) or under 75 years old (Younger: n=157).
Results: During mean follow-up period of 6.7 years, 173 patients (59%) underwent any late revascularization, including 50 of late target lesion revascularization and 123 of new lesion revascularization. Onset form of recurrent ischemia as acute coronary syndrome (ACS) and stable angina were 80 cases (46%) and 93 cases (54%), respectively. Kaplan-Meier curve analysis revealed that, in Younger, the incidence of recurrent ischemia developed as ACS (recurrent-ACS) was significantly lower in patient with LDL-C <70 mg/dl than in patient with LDL-C 70 to <100 mg/dl (p=0.039); however, there was no difference between the two groups in Elderly (p=0.465). Instead, recurrent-ACS was less frequent in patient with LDL-C 70 to <100 mg/dl than in patient with LDL-C ≥100 mg/dl in Elderly (p=0.049). Taking statins reduced recurrent-ACS in both Elderly and Younger, however, any late revascularization decreased only in Younger.
Conclusions: Strict control of LDL-C <70 mg/dl was effective to reduce the incidence of recurrent-ACS in secondary prevention of Younger, however, reduction of LDL-C <70 mg/dl was not effective for Elderly. Less than 100 mg/dl might be enough for the target value of LDL-C lowering therapy in secondary prevention of Japanese elderly patients.
Author Disclosures: A. Endo: None. T. Okada: None. S. Ito: None. N. Watanabe: None. T. Ouch: None. N. Takahashi: None. H. Yoshitomi: None. K. Tanabe: None.
- © 2016 by American Heart Association, Inc.