Statin therapy for primary prevention in adults aged 80 years and older was associated with lower mortality and fewer coronary events in a retrospective cohort study using electronic health record data.
Evidence for statin use in this age group remains limited, with current guidelines offering no clear recommendation for primary prevention beyond age 75. Researchers evaluated outcomes in patients aged ≥80 years without prior cardiovascular disease.
The analysis included 15,745 patients from Clalit Health Services in Israel (66% female), of whom 8413 were persistent statin users. Patients with prior cardiovascular disease (CVD), dialysis, or death within 1 year were excluded.
Outcomes included all-cause mortality, incident coronary events, and diagnoses of myopathy, diabetes mellitus, and dementia. Results were adjusted for demographic and clinical factors using Cox proportional hazards models.
Over a mean follow-up of approximately 4 years, mortality was lower among statin users. Separation between groups was evident over time. Mortality occurred in 20% of statin-treated patients compared with 37% of nonusers.
Statin use was also associated with fewer new coronary events. Incidence rates were 167 per 10,000 patient-years in the statin group and 174 per 10,000 patient-years in the nonstatin group. No statistically significant differences were observed in adverse outcomes, including myopathy, diabetes, or dementia.
Treatment continuity was associated with outcomes. Patients who discontinued statins before age 80 did not show similar reductions in coronary events, whereas those continuing therapy beyond age 80 had lower event rates.
The study is limited by its retrospective design and reliance on electronic health record coding, with potential for residual confounding. Cardiovascular-specific mortality and staging data were not available.
Overall, statin use in adults aged 80 years and older without prior CVD was associated with improved survival and fewer coronary events over approximately 4 years of follow-up, with no observed increase in adverse outcomes.
The authors reported no conflicts of interest and no external funding.
