Benefits of achieving the NCEP optional LDL-C goal among elderly patients with ACS.
OBJECTIVE
To assess the efficacy and safety of the achievement of the NCEP goal of LDL-C <1.8 mmol/L in elderly patients with ACS.


RESULTS
The relationship between LDL-C at 30 days after ACS and subsequent clinical outcomes were compared among elderly patients (aged > or =70 years) vs. younger counterparts in the PROVE IT-TIMI 22 trial, using the composite endpoint of death, myocardial infarction, or unstable angina. Among 634 elderly patients, the achievement of the NCEP goal was associated with an 8% absolute and a 40% relative lower risk of events [Hazard ratio (HR) 0.60, 95% confidence interval (CI) 0.41-0.87, P = 0.008] vs. corresponding benefits of 2.3 and 26% in 3150 younger patients (HR 0.74, 95% CI 0.59-0.94, P = 0.013). The estimated number of events preventable among the elderly by the achievement of these goals was 80 events at 2 years for every 1000 patients at goal vs. those not at goal, compared with 23 events potentially prevented in younger patients. The incidence of major side effects among the elderly was similar to that in younger patients and did not differ with the intensity of the statin regimen.


CONCLUSIONS
Among elderly ACS patients, achieving the new NCEP LDL-C optional goal as part of a secondary prevention strategy can be both as safe and effective as in younger patients.
Ray
Kausik K
KK
The TIMI Study Group and Cardiovascular Division, Department of Medicine, Brigham & Women's Hospital/Harvard Medical School, Boston, MA 02115, USA. koshray@gmail.com
Bach
Richard G
RG
Cannon
Christopher P
CP
Cairns
Richard
R
Kirtane
Ajay J
AJ
Wiviott
Stephen D
SD
McCabe
Carolyn H
CH
Braunwald
Eugene
E
Gibson
C Michael
CM
D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D003327:Coronary Disease / Q000097:blood / Q000401:mortality / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000097:blood / Q000401:mortality / Q000517:prevention & control*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality / Q000517:prevention & control; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome
D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL