title: Cognitive and Physical Function by Statin Exposure in Elderly Individuals Following Acute Myocardial Infarction.
abstract: Despite beneficial effects on morbidity and mortality after acute myocardial infarction (AMI), concerns remain about the safety of statin therapy, particularly their potential effects on cognitive and physical function, in elderly individuals. Among statin-naive AMI patients age ≥ 65 years in a multicenter US registry, we examined the association between statin prescription at discharge and change in cognition (via Modified Telephone Interview for Cognitive Status [TICS-M]) assessed at 1 and 6 months after AMI. Short Form-12 Physical Component score, hand grip, walk time, and chair-rise tests were used to assess physical function. We conducted noninferiority testing to evaluate the hypothesis that the mean change in cognitive function was no worse among patients recently started on statins compared with those who were not. Among 317 elderly AMI patients, 262 patients (83%) were prescribed a statin at discharge and 55 were not. After matching for propensity to be discharged on statin after AMI, the effect of statin treatment on change in TICS-M from 1 to 6 months (estimated difference, 0.11 points; 95% confidence interval: -2.11 to 2.32, P = 0.92) showed noninferiority (inferiority threshold 3 points). There were no significant differences in any physical function measure. Among statin-naive elderly individuals recovering from AMI, initiation of statin therapy was not associated with detectable changes in short-term cognitive or physical function. These findings support the general safety of statin therapy for secondary prevention in this population.
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Department of Medicine, Baltimore, Maryland.
authors.forename: Kristopher J
authors.initials: KJ
authors.lastname: Swiger
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Department of Medicine, Baltimore, Maryland.
authors.forename: Seth S
authors.initials: SS
authors.lastname: Martin
authors.affiliation: Saint Luke's Mid America Heart Institute/University of Missouri, Department of Cardiovascular Outcomes Research, Kansas City, Missouri.
authors.forename: Fengming
authors.initials: F
authors.lastname: Tang
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Department of Medicine, Baltimore, Maryland.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Department of Medicine, Baltimore, Maryland.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.affiliation: Outcomes Research and Assessment Group and Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.
authors.forename: Karen P
authors.initials: KP
authors.lastname: Alexander
authors.affiliation: Saint Luke's Mid America Heart Institute/University of Missouri, Department of Cardiovascular Outcomes Research, Kansas City, Missouri.
authors.forename: Suzanne V
authors.initials: SV
authors.lastname: Arnold
authors.affiliation: Saint Luke's Mid America Heart Institute/University of Missouri, Department of Cardiovascular Outcomes Research, Kansas City, Missouri.
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000187:drug effects*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D009043:Motor Activity / Q000187:drug effects*; D009203:Myocardial Infarction / Q000188:drug therapy*; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome; D014481:United States
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors