Statin discontinuation translates to increased cardiovascular risk in elderly

Discontinuation of statins leads to an increased risk of hospital admission for a cardiovascular event in elderly primary prevention patients, a study has found.

Researchers used data from the French national healthcare databases and identified 120,173 individuals who turned 75 years in 2012–2014. All participants had no history of cardiovascular disease and had a statin medication possession ratio ≥80 percent in each of the previous 2 years.

Over a mean follow-up of 2.4 years, 17,204 discontinued statins (defined as 3 consecutive months without exposure) and 5,396 patients were admitted for cardiovascular events (crude incidence rate, 2.1 per 100 patient-years). Of the patients who developed cardiovascular events, 2,299 had a coronary event, 2,328 had a cerebrovascular event and 769 had another vascular event. There were 3,243 patients who died during follow-up with no previous admission for cardiovascular events, including 1,005 (31.0 percent) who died outside of hospital.

Multivariable Cox hazards analysis revealed that compared with continued statin use, statin discontinuation was associated with increased risk of developing any cardiovascular event (hazard ratio [HR], 1.33, 95 percent CI, 1.18–1.50, coronary event (HR, 1.46, 1.21–1.75), cerebrovascular event (HR, 1.26, 1.05–1.51) or other vascular event (HR, 1.02, 0.74–1.40).

The present data are consistent with the reported relationship between low-density lipoprotein levels and cardiovascular risk, according to the researchers. More studies are needed to validate the findings and support updating and clarification of guidelines on the use of statins for primary prevention in the elderly.