Document Detail

Cardiovascular and cancer mortality in very elderly post-myocardial infarction patients receiving statin treatment.
MedLine Citation:
PMID:  20338498     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this study was to determine whether statin treatment is effective and safe in very elderly (80 years and older) acute myocardial infarction (AMI) patients. BACKGROUND: Elderly individuals constitute an increasing percentage of patients admitted to hospitals for AMI. Despite that these patients have a higher mortality risk, the application of evidence-based medicine remains much lower than for younger patients. METHODS: We included all patients 80 years and older who were admitted with the diagnosis of AMI in the Register of Information and Knowledge About Swedish Heart Intensive Care Admissions between 1999 and 2003 (n = 21,410). Of these, complete covariate and follow-up data were available for 14,907 patients (study population A). To limit the bias related comorbidity on statin therapy, we also performed analyses excluding patients who died within 14 days of the acute event (study population B) and all patients who died within 365 days (study population C). A propensity score was used to adjust for initial differences between treatment groups. RESULTS: All-cause mortality was significantly lower in patients receiving statin treatment at discharge in study population A (relative risk: 0.55, 95% confidence interval: 0.51 to 0.59), in study population B (relative risk: 0.65; 95% confidence interval: 0.60 to 0.71), and in study population C (relative risk: 0.66; 95% confidence interval: 0.59 to 0.76). Similar observations were made for cardiovascular mortality as well as for AMI mortality. There was no increase in cancer mortality in statin-treated patients. CONCLUSIONS: Statin treatment is associated with lower cardiovascular mortality in very elderly post-infarction patients without increasing the risk of the development of cancer.
Klas Gr?nsbo; Olle Melander; Lars Wallentin; Johan Lindb?ck; Ulf Stenestrand; J?rg Carlsson; Jan Nilsson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  55     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-26     Completed Date:  2010-04-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1362-9     Citation Subset:  AIM; IM    
Department of Clinical Sciences, Malm? University Hospital, Malm?, Sweden; Lund University, Lund, Sweden.
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MeSH Terms
Aged, 80 and over
Cardiovascular Diseases / mortality
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Myocardial Infarction / drug therapy*,  epidemiology,  mortality*
Neoplasms / epidemiology,  mortality*
Survival Analysis
Sweden / epidemiology
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

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