Comparative effectiveness of statins in secondary prevention among the older people aged 75 years and over

Kwak, Arim; Kim, Jae Hyun; Choi, Cheol Ung; Kim, In Wha; Oh, Jung Mi; Kim, Kyungim

doi:10.1007/s11096-019-00810-w

Cited by 4 publications

(2 citation statements)

References 36 publications

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“…In the subgroup analysis, significant reductions in primary and secondary endpoints were observed only in patients <65 years of age compared to 65 to 80 years of age [ 25 ]. Kwak A. et al [ 26 ] reported that moderate-intensity statin can be more protective against ischemic cardiovascular and cerebrovascular events compared with high-intensity statin in patients aged 75 years and older. Foody J.M.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of statin intensity according to age in patients with acute myocardial infarction

Lee

Kim

et al. 2022

PLoS ONE

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Background The available data are not sufficient to understand the clinical impact of statin intensity in elderly patients who undergo percutaneous coronary intervention (PCI) due to acute myocardial infarction (AMI). Methods Using the COREA-AMI registry, we sought to compare the clinical impact of high- versus low-to-moderate-intensity statin in younger (<75 years old) and elderly (≥75 years old) patients. Of 10,719 patients, we included 8,096 patients treated with drug-eluting stents. All patients were classified into high-intensity versus low-to-moderate-intensity statin group according to statin type and dose at discharge. The primary end point was target-vessel failure (TVF), a composite of cardiovascular death, target-vessel MI, or target-lesion revascularization (TLR) from 1 month to 12 months after index PCI. Results In younger patients, high-intensity statin showed the better clinical outcomes than low-to-moderate-intensity statin (TVF: 79 [5.4%] vs. 329 [6.8%], adjusted hazard ratio [aHR] 0.76; 95% confidence interval [CI] 0.59–0.99; P = 0.038). However, in elderly patients, the incidence rates of the adverse clinical outcomes were similar between two statin-intensity groups (TVF: 38 [11.4%] vs. 131 [10.6%], aHR 1.1; 95% CI 0.76–1.59; P = 0.63). Conclusions In this AMI cohort underwent PCI, high-intensity statin showed the better 1-year clinical outcomes than low-to-moderate-intensity statin in younger patients. Meanwhile, the incidence rates of adverse clinical events between high- and low-to-moderate-intensity statin were not statistically different in elderly patients. Further randomized study with large elderly population is warranted.

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Section: Discussionmentioning

confidence: 99%

Clinical impact of statin intensity according to age in patients with acute myocardial infarction

Lee

Kim

et al. 2022

PLoS ONE

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“…Despite hydrophilic statins such as rosuvastatin showing strong efficacy in lowering cholesterol and preventing cardiovascular disease 77,78 , a number of studies have suggested increased benefits of lipophilic statins 20,21,79 . For instance the PRIMO study (Prédiction du Risque Musculaire en Observationnel; Prediction of Muscular Risk in Observational conditions) investigated muscular symptoms in a population of approximately 8,000 hyperlipidemic patients treated with statins 80 .…”

Section: Discussionmentioning

confidence: 99%

Statin-specific inhibition of Rab-GTPase regulates cPKC-mediated IKs internalization

Ronzier

Parks

Qudsi

et al. 2019

Sci Rep

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Statins are prescribed for prevention and treatment of coronary artery disease. Statins have different cholesterol lowering abilities, with rosuvastatin and atorvastatin being the most effective, while statins like simvastatin and fluvastatin having lower effectiveness. Statins, in addition to their cholesterol lowering effects, can prevent isoprenylation of Rab-GTPase proteins, a protein family important for the regulation of membrane-bound protein trafficking. Here we show that endosomal localization of Rab-GTPases (Rab5, Rab7 and Rab11) was inhibited in a statin-specific manner, with stronger effects by fluvastatin, followed by simvastatin and atorvastatin, and with a limited effect by rosuvastatin. Fluvastatin inhibition of Rab5 has been shown to mediate cPKC-dependent trafficking regulation of the cardiac delayed rectifier KCNQ1/KCNE1 channels. We observed statin-specific inhibition of channel regulation consistent with statin-specific Rab-GTPase inhibition both in heterologous systems and cardiomyocytes. Our results uncover a non-cholesterol-reducing statin-specific effect of statins. Because Rab-GTPases are important regulators of membrane trafficking they may underlie statin specific pleiotropic effects. Therefore, statin-specificity may allow better treatment tailoring.

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Comparison of statins for primary prevention of cardiovascular disease and persistent physical disability in older adults

Zhou

Curtis

Ernst

et al. 2021

Eur J Clin Pharmacol

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Comparative effectiveness of statins in secondary prevention among the older people aged 75 years and over

Cited by 4 publications

References 36 publications

Clinical impact of statin intensity according to age in patients with acute myocardial infarction

Clinical impact of statin intensity according to age in patients with acute myocardial infarction

Statin-specific inhibition of Rab-GTPase regulates cPKC-mediated IKs internalization

Comparison of statins for primary prevention of cardiovascular disease and persistent physical disability in older adults

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