title: Benefits of statins in elderly subjects without established cardiovascular disease: a meta-analysis.
abstract: OBJECTIVE
  The purpose of this paper was to assess whether statins reduce all-cause mortality and cardiovascular (CV) events in elderly people without established CV disease.
  
  
  BACKGROUND
  Because of population aging, prevention of CV disease in the elderly is relevant. In elderly patients with previous CV events, the use of statins is recommended by guidelines, whereas the benefits of these drugs in elderly subjects without previous CV events are still debated.
  
  
  METHODS
  Randomized trials comparing statins versus placebo and reporting all-cause and CV mortality, myocardial infarction (MI), stroke, and new cancer onset in elderly subjects (age ≥ 65 years) without established CV disease were included.
  
  
  RESULTS
  Eight trials enrolling 24,674 subjects (42.7% females; mean age 73.0 ± 2.9 years; mean follow up 3.5 ± 1.5 years) were included in analyses. Statins, compared with placebo, significantly reduced the risk of MI by 39.4% (relative risk [RR]: 0.606 [95% confidence interval (CI): 0.434 to 0.847]; p = 0.003) and the risk of stroke by 23.8% (RR: 0.762 [95% CI: 0.626 to 0.926]; p = 0.006). In contrast, the risk of all-cause death (RR: 0.941 [95% CI: 0.856 to 1.035]; p = 0.210) and of CV death (RR: 0.907 [95% CI: 0.686 to 1.199]; p = 0.493) were not significantly reduced. New cancer onset did not differ between statin- and placebo-treated subjects (RR: 0.989 [95% CI: 0.851 to 1.151]; p = 0.890).
  
  
  CONCLUSIONS
  In elderly subjects at high CV risk without established CV disease, statins significantly reduce the incidence of MI and stroke, but do not significantly prolong survival in the short-term.
authors: Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors: Gianluigi
authors: G
authors: Savarese
authors: Antonio M
authors: AM
authors: Gotto
authors: Stefania
authors: S
authors: Paolillo
authors: Carmen
authors: C
authors: D'Amore
authors: Teresa
authors: T
authors: Losco
authors: Francesca
authors: F
authors: Musella
authors: Oriana
authors: O
authors: Scala
authors: Caterina
authors: C
authors: Marciano
authors: Donatella
authors: D
authors: Ruggiero
authors: Fabio
authors: F
authors: Marsico
authors: Giuseppe
authors: G
authors: De Luca
authors: Bruno
authors: B
authors: Trimarco
authors: Pasquale
authors: P
authors: Perrone-Filardi
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D057194:Intention to Treat Analysis; D008055:Lipids / Q000097:blood; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000517:prevention & control; D020521:Stroke / Q000401:mortality / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids
keywords: CI; CV; LDL; MI; RR; cardiovascular; cardiovascular risk; confidence interval; elderly; low-density lipoprotein; myocardial infarction; primary prevention; relative risk; statins