Association of Statin Use With Disability-Free Survival and Cardiovascular Disease Among Healthy Older Adults
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© 2020 American College of Cardiology
Foundation Background: There is clinical uncertainty regarding the benefits and harms of prescribing statins in healthy subjects ≥70 years of age. Objectives: The aim of this study was to examine the association among statins, dementia-free and disability-free survival, and cardiovascular disease (CVD) among healthy older adults using data from the ASPREE (Aspirin in Reducing Events in the Elderly) trial. Methods: ASPREE was a randomized trial of 19,114 community-dwelling persons in Australia and the United States ≥65 years of age and free of documented CVD, dementia, and disability. Data were collected for those ≥70 years of age, and participants who took statins at baseline were compared with those who did not using Cox proportional hazards regression with inverse probability weighting. The primary outcome, referred to as “disability-free survival,” was a composite of all-cause mortality, dementia, or persistent physical disability. Other outcomes included the individual components of the composite outcome, major adverse cardiovascular events, fatal CVD, myocardial infarction, and stroke. Results: Of the 18,096 included participants (median age 74.2 years, 56.0% women), 5,629 took statins at baseline. Over a median follow-up period of 4.7 years, baseline statin use was not associated with disability-free survival or with the risk for all-cause mortality or dementia. However, it was associated with lower risks for physical disability and all cardiovascular outcomes. Conclusions: Among healthy community-dwelling adults ≥70 years of age, statin use may be beneficial for preventing physical disability and CVD but not beneficial for prolonging disability-free survival or avoiding death or dementia. Future clinical trials are needed to confirm these findings.
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McNeil, J.; Woods, R.; Nelson, M.; Reid, Christopher; Kirpach, B.; Wolfe, R.; Storey, E.; Shah, R.; Lockery, J.; Tonkin, A.; Newman, A.; Williamson, J.; Margolis, K.; Ernst, M.; Abhayaratna, W.; Stocks, N.; Fitzgerald, S.; Orchard, S.; Trevaks, R.; Beilin, L.; Donnan, G.; Gibbs, P.; Johnston, C.; Ryan, J.; Radziszewska, B.; Grimm, R.; Murray, A. (2018)Background: Information on the use of aspirin to increase healthy independent life span in older persons is limited. Whether 5 years of daily low-dose aspirin therapy would extend disabilityfree life in healthy seniors ...
McNeil, J.; Nelson, M.; Woods, R.; Lockery, J.; Wolfe, R.; Reid, Christopher; Kirpach, B.; Shah, R.; Ives, D.; Storey, E.; Ryan, J.; Tonkin, A.; Newman, A.; Williamson, J.; Margolis, K.; Ernst, M.; Abhayaratna, W.; Stocks, N.; Fitzgerald, S.; Orchard, S.; Trevaks, R.; Beilin, L.; Donnan, G.; Gibbs, P.; Johnston, C.; Radziszewska, B.; Grimm, R.; Murray, A. (2018)Background: In the primary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial, now published in the Journal, we report that the daily use of aspirin did not provide a benefit with regard to the primary ...
Baseline Characteristics of Participants in the ASPREE (ASPirin in Reducing Events in the Elderly) StudyMcNeil, J.; Woods, R.; Nelson, M.; Murray, A.; Reid, Christopher; Kirpach, B.; Storey, E.; Shah, R.; Wolfe, R.; Tonkin, A.; Newman, A.; Williamson, J.; Lockery, J.; Margolis, K.; Ernst, M.; Abhayaratna, W.; Stocks, N.; Fitzgerald, S.; Trevaks, R.; Orchard, S.; Beilin, L.; Donnan, G.; Gibbs, P.; Johnston, C.; Grimm, R.; ASPREE Investigator Group (2017)Background: There are no primary prevention trials of aspirin with relevant geriatric outcomes in elderly people. ASPirin in Reducing Events in the Elderly (ASPREE) is a placebo-controlled trial of low-dose aspirin that ...