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Zeitschrift für Gerontologie und Geriatrie

, Volume 51, Issue 8, pp 880–886 | Cite as

Gender differences in mortality among statin users aged 80 years or more

  • Dan Justo
  • Mark Tchernichovsky
  • Anjelika Kremer
  • Erel Joffe
  • Shany Sherman
  • Marina Ioffe
  • Haim Mayan
Original contribution
  • 175 Downloads

Abstract

Background

Little is known about the prognosis associated with statin therapy and its gender differences in older adults aged ≥80 years.

Objective

To study the mortality and survival associated with statin therapy and their gender differences in older adults aged ≥80 years.

Method

This was a historical prospective study conducted at a tertiary medical center. The medical charts of all older adults aged ≥80 years who had been admitted to a single internal medicine department during 1 year were reviewed. All-cause 3‑year mortality and survival rates following hospital admission in men and in women using statins were investigated.

Results

The final cohort included 216 patients: 122 (56.5%) women, mean age 85.3 ± 3.9 years. Overall, 66 (53.2%) women and 58 (46.8%) men used statins for 3 years or more following hospital admission. During this time 48 (39.3%) women and 48 (51.1%) men died. The all-cause 3‑year mortality rates were significantly lower only in women who had used statins compared with women who had not used statins (24.2% vs. 57.1%; relative risk = 0.2; 95% confidence interval 0.1–0.5; p < 0.0001). The 3‑year cumulative survival rates were significantly higher in women who had used statins as part of primary as well as secondary cardiovascular prevention (p < 0.0001 and p = 0.014, respectively). A Cox regression analysis showed that statin therapy was independently associated with low 3‑year cumulative mortality rates in women (hazard ratio=0.3; 95% confidence interval=0.1–0.6; p = 0.001).

Conclusion

In older adults aged ≥80 years, statin therapy is associated with high 3‑year cumulative survival rates only in women.

Keywords

Survival Cardiovascular disease Observational study Polypharmacy Prognosis 

Geschlechtsunterschiede in der Mortalität von Statinanwendern im Alter von ≥80 Jahren

Zusammenfassung

Hintergrund

Über die mit einer Statintherapie assoziierte Prognose und die Geschlechtsunterschiede bei älteren Menschen (≥80 Jahre) ist wenig bekannt.

Ziel

Ziel war es, die Mortalitäts- und Überlebensrate sowie die Geschlechtsunterschiede bei einer Statintherapie bei älteren Menschen (≥80 Jahre) zu untersuchen.

Methode

Eine historische prospektive Studie wurde in einem tertiären medizinischen Zentrum durchgeführt. Es erfolgte die Überprüfung der Patientenakten aller älteren Patienten (≥80 Jahre), die im 1. Jahr einer einzelnen Abteilung für Innere Medizin zugewiesen wurden. Die 3‑Jahres-Mortalität jeglicher Ursache und die Überlebensraten nach Krankenhauseinweisung bei Männern und Frauen, die Statine einnahmen, wurden untersucht.

Ergebnisse

In die finale Kohorte wurden 216 Patienten eingeschlossen, davon 122 (56,5%) Frauen (mittleres Alter: 85,3 ± 3,9 Jahre). Insgesamt nahmen 66 (53,2%) Frauen und 58 (46,8%) Männer Statine für 3 Jahre oder länger nach einer Krankenhauseinweisung ein. Während dieser Zeit starben 48 (39,3%) Frauen und 48 (51,1%) Männer. Die 3‑Jahres-Mortalitätsrate jeglicher Ursache war nur bei Frauen, die Statine einnahmen, signifikant geringer als bei Frauen, die keine Statine einnahmen (24,2% vs. 57,1%; relatives Risiko: 0,2; 95% Konfidenzintervall [CI] 0,1–0,5; p < 0.0001). Die kumulative Überlebensrate war signifikant höher bei Frauen, die als Teil der kardiovaskulären Primär- und Sekundärprävention Statine einnahmen (p < 0,0001 bzw. p = 0,014). Eine Cox-Regressionsanalyse zeigte, dass eine Statintherapie unabhängig mit einer geringeren 3‑Jahres-Mortalitätsrate bei Frauen assoziiert war (Hazard-Ratio 0,3; 95% CI 0,1–0,6; p = 0,001).

Schlussfolgerung

Bei älteren Menschen (≥80 Jahre) ist eine Statintherapie nur bei Frauen mit einer hohen kumulativen 3‑Jahres-Überlebensrate assoziiert.

Schlüsselwörter

Überleben Kardiovaskuläre Erkrankung Beobachtungsstudie Multimedikation Prognose 

Notes

Compliance with ethical guidelines

Conflict of interest

D. Justo, M. Tchernichovsky, A. Kremer, E. Joffe, S. Sherman, M. Ioffe and H. Mayan declare that they have no competing interests.

This contribution depicts a historical prospective study which does not interfere with therapy.

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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  • Dan Justo
    • 1
    • 2
  • Mark Tchernichovsky
    • 3
  • Anjelika Kremer
    • 1
  • Erel Joffe
    • 2
  • Shany Sherman
    • 4
  • Marina Ioffe
    • 4
  • Haim Mayan
    • 2
    • 4
  1. 1.Geriatrics DivisionSheba Medical CenterTel-HashomerIsrael
  2. 2.Sackler School of MedicineTel-Aviv UniversityTel-AvivIsrael
  3. 3.Rappaport School of MedicineTechnion – Israel Institute of TechnologyHaifaIsrael
  4. 4.Internal Medicine ESheba Medical CenterTel-HashomerIsrael

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