title: Effect of statin therapy on cardiovascular outcomes after coronary revascularization in patients ≥ 80 years of age: observations from the CREDO-Kyoto Registry Cohort-2.
abstract: OBJECTIVE
  Effects of statin therapy on cardiovascular outcomes in super-elder population ≥ 80 years of age have been poorly understood, despite its established role in non-super-elder population.
  
  
  METHODS
  Among 14,834 patients undergoing first coronary revascularization in the CREDO-Kyoto Registry Cohort-2, patients were divided into 2 strata based on age and patients in each stratum were further divided into 2 groups based on statin therapy at discharge; ≥ 80 years of age: 2017 patients (statin group: N = 765, no-statin group: N = 1252) and <80 years of age: 12,817 patients (statin group: N = 6523, no-statin group: N = 6294).
  
  
  RESULTS
  Through 5-year follow-up, cumulative incidences of major adverse cardiovascular events (MACE: composite of cardiovascular death, myocardial infarction and stoke) were significantly lower in the statin group than in the no-statin group in both strata (23.4% versus 32.0%, P = 0.0003 in patients ≥ 80 years of age and 11.5% versus 16.1%, P < 0.0001 in patients <80 years of age). After adjusting confounders, statin therapy was associated with significantly reduced risk for MACE not only in patients <80 years of age (hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.74-0.91, P < 0.0001), but also in patients ≥ 80 years of age (HR 0.77, 95% CI 0.64-0.93, P = 0.006). There was no interaction between age and the effect of statins (P interaction = 0.86).
  
  
  CONCLUSIONS
  Statin therapy at discharge from first coronary revascularization was associated with significantly reduced risk for cardiovascular events even in patients ≥ 80 years of age. There was no difference in the direction and magnitude of treatment effect of statins between the super-elder and non-super-elder patients.
authors.affiliation: Division of Cardiology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Natsuaki
authors.affiliation: Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.affiliation: Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Furukawa
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shiomi
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Koh
authors.initials: K
authors.lastname: Ono
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: taketaka@kuhp.kyoto-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D009204:Myocardial Revascularization; D010351:Patient Discharge; D016016:Proportional Hazards Models; D012042:Registries; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Coronary artery disease; Elderly patients; Statin