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Relation of Statin Use and Mortality in Community-Dwelling Frail Older Patients With Coronary Artery Disease

A. Pilotto, P. Gallina, F. Panza, M. Copetti, A. Cella, A. Cruz-Jentoft, J. Daragjati, L. Ferrucci, S. Maggi, F. Mattace-Raso, M. Paccalin, MC. Polidori, E. Topinkova, G. Trifirò, AK. Welmer, T. Strandberg, N. Marchionni, . ,

. 2016 ; 118 (11) : 1624-1630. [pub] 20160830

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, multicentrická studie, pozorovací studie

Perzistentní odkaz   https://www.medvik.cz/link/bmc17023679
E-zdroje Online Plný text

NLK ProQuest Central od 2012-08-15 do Před 2 měsíci
Nursing & Allied Health Database (ProQuest) od 2012-08-15 do Před 2 měsíci
Health & Medicine (ProQuest) od 2012-08-15 do Před 2 měsíci

Odkazy

PubMed 27670793
DOI 10.1016/j.amjcard.2016.08.042
Knihovny.cz E-zdroje

Clinical decision-making for statin treatment in older patients with coronary artery disease (CAD) is under debate, particularly in community-dwelling frail patients at high risk of death. In this retrospective observational study on 2,597 community-dwelling patients aged ≥65 years with a previous hospitalization for CAD, we estimated mortality risk assessed with the Multidimensional Prognostic Index (MPI), based on the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons (SVaMA), used to determine accessibility to homecare services/nursing home admission in 2005 to 2013 in the Padua Health District, Veneto, Italy. Participants were categorized as having mild (MPI-SVaMA-1), moderate (MPI-SVaMA-2), and high (MPI-SVaMA-3) baseline mortality risk, and propensity score-adjusted hazard ratios (HRs) of 3-year mortality rate were calculated according to statin treatment in these subgroups. Greater MPI-SVaMA scores were associated with lower rates of statin treatment and higher 3-year mortality rate (MPI-SVaMA-1 = 23.4%; MPI-SVaMA-2 = 39.1%; MPI-SVaMA-3 = 76.2%). After adjusting for propensity score quintiles, statin treatment was associated with lower 3-year mortality risk irrespective of MPI-SVaMA group (HRs [95% confidence intervals] 0.45 [0.37 to 0.55], 0.44 [0.36 to 0.53], and 0.28 [0.21 to 0.39] in MPI-SVaMA-1, -2, and -3 groups, respectively [interaction test p = 0.202]). Subgroup analyses showed that statin treatment was also beneficial irrespective of age (HRs [95% confidence intervals] 0.38 [0.27 to 0.53], 0.45 [0.38 to 0.54], and 0.44 [0.37 to 0.54] in 65 to 74, 75 to 84, and ≥85 year age groups, respectively [interaction test p = 0.597]). In conclusion, in community-dwelling frail older patients with CAD, statin treatment was significantly associated with reduced 3-year mortality rate irrespective of age and multidimensional impairment, although the frailest patients were less likely to be treated with statins.

Citace poskytuje Crossref.org

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