Effect of statin therapy on cardiovascular outcomes after coronary revascularization in patients ≥ 80 years of age: observations from the CREDO-Kyoto Registry Cohort-2.

OBJECTIVE: Effects of statin therapy on cardiovascular outcomes in super-elder population ≥ 80 years of age have been poorly understood, despite its established role in non-super-elder population.

METHODS: Among 14,834 patients undergoing first coronary revascularization in the CREDO-Kyoto Registry Cohort-2, patients were divided into 2 strata based on age and patients in each stratum were further divided into 2 groups based on statin therapy at discharge; ≥ 80 years of age: 2017 patients (statin group: N = 765, no-statin group: N = 1252) and <80 years of age: 12,817 patients (statin group: N = 6523, no-statin group: N = 6294).

RESULTS: Through 5-year follow-up, cumulative incidences of major adverse cardiovascular events (MACE: composite of cardiovascular death, myocardial infarction and stoke) were significantly lower in the statin group than in the no-statin group in both strata (23.4% versus 32.0%, P = 0.0003 in patients ≥ 80 years of age and 11.5% versus 16.1%, P < 0.0001 in patients <80 years of age). After adjusting confounders, statin therapy was associated with significantly reduced risk for MACE not only in patients <80 years of age (hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.74-0.91, P < 0.0001), but also in patients ≥ 80 years of age (HR 0.77, 95% CI 0.64-0.93, P = 0.006). There was no interaction between age and the effect of statins (P interaction = 0.86).

CONCLUSIONS: Statin therapy at discharge from first coronary revascularization was associated with significantly reduced risk for cardiovascular events even in patients ≥ 80 years of age. There was no difference in the direction and magnitude of treatment effect of statins between the super-elder and non-super-elder patients.