ArticleArchives of medical science : AMS2013
Statins and cardiovascular outcomes in elderly and younger patients with coronary artery disease: a post hoc analysis of the GREACE study.
Article in Archives of medical science : AMS, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Bone Health in Patients with Dyslipidemias: An Underestimated Aspect.International journal of molecular sciences · 2022Review
- Pharmacological Treatment for Non-alcoholic Fatty Liver Disease.Advances in therapy · 2019Review
- Management and risk factor control of coronary artery disease in elderly versus nonelderly: a multicenter registry.Journal of geriatric cardiology : JGC · 2016Article
- The Relationship Between Hemodialysis and the Echocardiographic Findings in Patients with Chronic Kidney Disease.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2016Article
- Adding carotid total plaque area to the Framingham risk score improves cardiovascular risk classification.Archives of medical science : AMS · 2016Article
- Lipids, blood pressure and kidney update 2015.Lipids in health and disease · 2015Review
- Ear lobe crease: a marker of coronary artery disease?Archives of medical science : AMS · 2015Article
- GPs' perspectives on secondary cardiovascular prevention in older age: a focus group study in the Netherlands.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Article
- Objectives and methodology of Romanian SEPHAR II Survey. Project for comparing the prevalence and control of cardiovascular risk factors in two East-European countries: Romania and Poland.Archives of medical science : AMS · 2015Article
- Statin intolerance - an attempt at a unified definition. Position paper from an International Lipid Expert Panel.Archives of medical science : AMS · 2015Article
- Danqi Pill regulates lipid metabolism disorder induced by myocardial ischemia through FATP-CPTI pathway.BMC complementary and alternative medicine · 2015Article
- High levels of LDL-C combined with low levels of HDL-C further increase platelet activation in hypercholesterolemic patients.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2015Article
- Heart function disturbances in chronic kidney disease - echocardiographic indices.Archives of medical science : AMS · 2014Article
- Lipid, blood pressure and kidney update 2013.International urology and nephrology · 2014Review
- Statin treatment in the elderly: how much do we know?Archives of medical science : AMS · 2013Article
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Authors and funding
11 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionThe effect of cardiovascular disease (CVD) prevention measures aimed at elderly patients requires further evidence. We investigated the effect of statin treatment (targeted to achieve guideline goals) on CVD outcomes in different age groups to determine whether statins are more beneficial in the elderly. MATERIAL AND
methodsThe primary endpoint of this post hoc analysis of the GREek Atorvastatin and Coronary-heart-disease Evaluation (GREACE) study (n = 1,600 patients with established coronary heart disease (CHD), mean follow-up 3 years) was the absolute and relative CVD event (a composite of death, myocardial infarction, revascularization, unstable angina, heart failure and stroke) risk reduction in age quartiles (each n = 200). Patients on "structured care" with atorvastatin (n = 800) followed up by the university clinic and treated to lipid goal were compared with the corresponding quartiles on "usual care" (n = 800) followed up by specialists or general practitioners of the patient's choice outside the hospital.
resultsIn the elderly (mean age 69 ±4 and 70 ±3 years in the "structured" and "usual care", respectively) the absolute CVD event reduction between "structured" and "usual care" was 16.5% (p < 0.0001), while in the younger patients (mean age 51 ±3 years and 52 ±3 years in the "structured" and "usual care", respectively) this was 8.5% (p = 0.016); relative risk reduction (RRR) 60% (p < 0.0001) vs. 42% respectively (p = 0.001). The elderly had higher rates of chronic kidney disease and higher uric acid levels, plus an increased prevalence of diabetes, metabolic syndrome and non-alcoholic fatty liver disease. These factors might contribute to the increased CVD risk in older patients.
conclusionsAll age groups benefited from statin treatment, but the elderly on "structured care" had a greater absolute and relative CVD risk reduction than the younger patients when compared with the corresponding patients assigned to "usual care". These findings suggest that we should not deprive older patients of CVD prevention treatment and lipid target achievement.
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