Safety and efficacy of statin treatment in very elderly patients / Segurança e eficácia do tratamento com estatinas em pacientes muito idosos

Abstract

Abstract
 Introduction and objectives: The treatment of dyslipidemia over 75 years old is not well elucidated, due to the non-inclusion in large randomized clinical trials. Elderly people develop atherosclerosis more often and the worldwide population shows greater longevity. To evaluate the efficacy and safety of statin in very elderly people. Methods: The patients were divided into two groups: over 75 years (very elderly) and up to 75 years (control group). We evaluated: coronary artery disease (CAD); stroke; clearance of creatinine; creatine phosphokinase (CPK) and transaminase (ALT, AST) levels; lipid profile; type, dosage, and time using a statin. Results: The sample of 120 patients, 53,2% male, age 74.1 (±11.1) years, 82.3 very elderly, and 64.9 years in the control group. The total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein (HDL-C) in very elderly and control were 162 and 166 (p=ns), 84 and 90 (p=ns), 52.5 and 47 mg/dL (p=0.07), respectively. CAD and stroke, respectively 52.5 and 78.8% (p=0.007), and 18.6 and 7.7% (p=0.09). The time using a statin and the number of drugs taken were the same in the groups. The CPK and ALT levels were 97 and 110 (p=ns) and 16.5 and 20 U/L (p=0.004), respectively. There was no statin dose reduction in the elderly group despite the higher proportion of clinical comorbidities or renal dysfunction. Conclusions: The statin treatment in very elderly patients is effective and safe. The increased risk of CAD and stroke in elderly people corroborate the importance of statin use in this age group.