Efficacy of statin treatment based on cardiovascular outcomes in elderly patients: a standard meta-analysis and Bayesian network analysis

• Published in: Journal of international medical research 2020-06, Vol.48 (6), p.300060520926349-300060520926349
• Main Authors: Zhai, Chuannan, Hou, Kai, Li, Rui, Hu, YueCheng, Zhang, JingXia, Zhang, YingYi, Wang, Le, Zhang, Rui, Cong, HongLiang
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Atorvastatin - therapeutic use; Bayes Theorem; Cardiovascular Diseases - drug therapy; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Incidence; Meta Analysis; Mortality; Prevention; Primary Prevention - methods; Randomized Controlled Trials as Topic; Secondary Prevention - methods; Statins; Treatment Outcome
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060520926349

Objective Statins have been shown to be beneficial for the prevention of cardiovascular events. In elderly individuals, the efficacy of statins remains controversial and the comparative effect of statins has not been assessed. Methods MEDLINE, Embase, and the Cochrane Central database were searched for randomized controlled trials that assessed statins in older patients. Results Seventeen trials were analyzed. When used for secondary prevention, statins were associated with reduced risk of cardiovascular events, all-cause mortality, cardiovascular mortality, revascularization, and stroke. When used for primary prevention, statins reduced the risk of myocardial infarction and revascularization, but did not significantly affect other outcomes. A modest difference between pharmaceutical statin products was found, and high-quality evidence indicated that intensive atorvastatin had the greatest benefits for secondary prevention. Conclusions In secondary prevention, evidence strongly suggests that statins are associated with a reduction in the risk of all-cause mortality, cardiovascular events, cardiovascular mortality, and revascularization. However, differences in the effects of various statins do not appear to have significant effects on therapy in secondary prevention for the elderly.