Early statin therapy in elderly patients presenting with acute coronary syndrome causing less heart failure.
OBJECTIVE
Elderly patients are less likely to receive statin therapy because of concerns about their side-effects. However, 80% of deaths related to coronary heart disease occur in patients above the age of 65 years. This study evaluated the potential benefit of early administration of statins in elderly patients presenting with an acute coronary syndrome.


METHODS
This was a prospective cohort study of 774 elderly patients (>65 years) with acute coronary syndrome. The patients were divided into two groups. The first group, consisting of 611 patients, received statins within the first 24 hours of admission, while the second group, consisting of 163 patients, received statins after the first 24 hours. The end points studied included death, heart failure/pulmonary edema, stroke and recurrent myocardial infarction during hospitalization.


RESULTS
Multivariable logistic regression analysis, adjusting for baseline demographics, co-morbidities and chronic statin therapy, showed that the occurrence of heart failure/pulmonary edema during hospitalization was relatively lower among those who received statins within 24 hours of admission (odds ratio: 0.5, 95% CI: 0.27-0.94, p=0.03). The C statistic for the model was 0.79.


CONCLUSIONS
Elderly patients presenting with acute coronary syndrome seem to benefit from early statin therapy, and have significantly lower rates of heart failure and pulmonary edema than those who are administered statins at a later stage.
Saab
Fadi A
FA
University of Michigan Cardiovascular Center, Ann Arbor, Michigan 48109-0047, USA.
Petrina
Mircea
M
Kline-Rogers
Eva
E
Fang
Jianming
J
Otten
Richard
R
Mukherjee
Debabrata
D
Eagle
Kim A
KA
D054058:Acute Coronary Syndrome / Q000150:complications / Q000188:drug therapy*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors