Is there a mortality benefit of statin use for secondary prevention of coronary artery disease (CAD) in an older population? Insights from the Melbourne Interventional Group (MIG) Registry.

Abstract

Aims: Intensive statin therapy reduces death and MACE in patients with CAD, although there is a paucity of evidence within the elderly population. We examined the use of statin therapy and long-term mortality benefits in an elderly population with CAD. Methods: Consecutive patients from the MIG registry (2014-2018) undergoing PCI were included. Patients were divided into <85 years and >85 years and statin use were examined. The primary endpoint was long-term mortality through National Death Index linkage (median follow-up 3.3 years). Results: The rate of statin use was higher in <85 years (95%) compared to >85 years (90%). In those <85 years, mortality was 15.1 vs. 29% (statin vs. no statin, p<0.001). There was no significant benefit seen in patients aged >85 years (48% vs. 55%, statin vs. no statin, p=0.21). There was a trend to a mortality benefit in the first two years after commencing therapy in >85 years as shown in the Cox regression analysis. Conclusions: Statin therapy did not have a significant impact on all-cause mortality of patients >85 years with CAD, though it did in younger patients. Whether this is due to factors associated with advancing age is yet to be determined.