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Lipid-Lowering Agents in Older Individuals: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

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dc.contributor.author Ponce, Oscar J.
dc.contributor.author Larrea-Mantilla, Laura
dc.contributor.author Hemmingsen, Bianca
dc.contributor.author Serrano, Valentina
dc.contributor.author Rodriguez-Gutierrez, Rene
dc.contributor.author Spencer-Bonilla, Gabriela
dc.contributor.author Alvarez-Villalobos, Neri
dc.contributor.author Benkhadra, Khaled
dc.contributor.author Haddad, Abdullah
dc.contributor.author Gionfriddo, Michael R.
dc.contributor.author Prokop, Larry J.
dc.contributor.author Brito, Juan P.
dc.contributor.author Murad, Mohammad Hassan
dc.date.accessioned 2019-07-04T17:00:18Z
dc.date.available 2019-07-04T17:00:18Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/6848
dc.description.abstract BACKGROUND: The efficacy of lipid-lowering agents on patient-important outcomes in older individuals is unclear. METHODS: We included randomized trials that enrolled individuals aged 65 years or older and that included at least 1 year of follow-up.Pairs of reviewers selected and appraised the trials. RESULTS: We included 23 trials that enrolled 60,194 elderly patients. For primary prevention, statins reduced the risk of coronary artery disease [CAD; relative risk (RR): 0.79, 95% CI: 0.68 to 0.91] and myocardial infarction (MI; RR: 0.45, 95% CI: 0.31 to 0.66) but not all-cause or cardiovascular mortality or stroke. These effects were imprecise in patients with diabetes, but there was no significant interaction between diabetes status and the intervention effect. For secondary prevention, statins reduced all-cause mortality (RR: 0.80, 95% CI: 0.73 to 0.89), cardiovascular mortality (RR: 0.68, 95% CI: 0.58 to 0.79), CAD (RR: 0.68, 95% CI: 0.61 to 0.77), MI (RR: 0.68, 95% CI: 0.59 to 0.79), and revascularization (RR: 0.68, 95% CI: 0.61 to 0.77). Intensive (vs less-intensive) statin therapy reduced the risk of CAD and heart failure. Niacin did not reduce the risk of revascularization, and fibrates did not reduce the risk of stroke, cardiovascular mortality, or CAD. CONCLUSION: High-certainty evidence supports statin use for secondary prevention in older individuals. Evidence for primary prevention is less certain. Data in older individuals with diabetes are limited; however, no empirical evidence has shown a significant difference based on diabetes status. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartof urn:issn:1945-7197
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject UNAVAILABLE en_US
dc.title Lipid-Lowering Agents in Older Individuals: A Systematic Review and Meta-Analysis of Randomized Clinical Trials en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1210/jc.2019-00195
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.18

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