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Does Statin Use in Frail Patients Provide Survival Benefits? Insights From a Meta-Analysis.
Mondal, Avilash; Li, Aobo; Edusa, Samuel; Gogineni, Anurag; Karipineni, Siddharth; Abdelhafez, Salma; Nalluri, Santosh Dheeraj; Meka, Gautham Gosh; Bawa, Jerrin; Puli, Srikanth; Venkata, Vikramaditya Samala; Vyas, Ankit; Jain, Akhil; Desai, Rupak.
Afiliación
  • Mondal A; Department of Internal Medicine, Nazareth Hospital, Philadelphia, PA.
  • Li A; Department of Internal Medicine, Beijing Anzhen Hospital, Beijing, China.
  • Edusa S; Department of Internal Medicine, Samalla Clinic Ltd., New Gbawe - Accra, Ghana.
  • Gogineni A; Department of Medicine, Nagarjuna Hospital, Vijayawada, Andhra Pradesh, India.
  • Karipineni S; Department of Internal Medicine, Osmania Medical College, Hyderabad, India.
  • Abdelhafez S; Faculty of Medicine, Ain Shams University, Cairo, Egypt.
  • Nalluri SD; Department of Internal Medicine, Osmania Medical College, Hyderabad, Telangana, India.
  • Meka GG; Department of Medicine, Andhra Medical College, Vishakhapatnam, Andhra Pradesh, India.
  • Bawa J; Department of Internal Medicine, Flushing Hospital, NY.
  • Puli S; Department of Hospital Medicine, Cheshire Medical Center, Dartmouth-Hitchcock, Keene, NH.
  • Venkata VS; Department of Hospital Medicine, Cheshire Medical Center, Dartmouth-Hitchcock, Keene, NH.
  • Vyas A; Vascular Medicine, Ochsner Clinic Foundation, New Orleans, LA.
  • Jain A; Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. Electronic address: ajain9@mdanderson.org.
  • Desai R; Atlanta, GA, USA.
Curr Probl Cardiol ; 49(1 Pt A): 102038, 2024 Jan.
Article en En | MEDLINE | ID: mdl-37597795
ABSTRACT
Frailty is a complex syndrome that increases with age and predisposes older adults to adverse outcomes, including mortality. Statins are proven to lower the risk of atherosclerotic cardiovascular disease, but there is limited data on their survival benefit in frail older people. This meta-analysis was conducted to determine whether statins can lower mortality in frail persons. A comprehensive search of PubMed, Google Scholar, and SCOPUS was conducted until September 2022 to identify studies reporting mortality outcomes with statin therapy in adults aged 75 with a validated frailty assessment. The pooled odds ratio for all-cause mortality was calculated using a random effects model. Leave-one-out method was used for sensitivity analysis. Of 5 studies (2013-2022) included (Total = 14,324, 3 prospective and 2 retrospectives, Males 49%, Mean follow-up duration 4.7 years), 41.6% (5971/14,324) were frail. 52.7% of patients were on a moderate-dose/no-statin, while 47.2% took a high-dose statin. Nonstatin users were older (83.35 vs 81.5) than users. Frail patients often had diabetes, hypertension, hyperlipidemia, a history of Stroke/MI, and dementia. High-dose atorvastatin was the most used statin. Pooled analysis revealed that statins lower all-cause mortality in elderly adults, however, the association was not significant (OR 0.67, 95% CI 0.38-1.18; P = 0.17). The meta-analysis demonstrated that using statins to reduce mortality in frail patients does not appear justifiable. Further prospective studies are needed to guide statin use among frail older adults for survival benefits.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inhibidores de Hidroximetilglutaril-CoA Reductasas / Accidente Cerebrovascular / Aterosclerosis / Fragilidad Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Aged / Humans / Male Idioma: En Revista: Curr Probl Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Panamá Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inhibidores de Hidroximetilglutaril-CoA Reductasas / Accidente Cerebrovascular / Aterosclerosis / Fragilidad Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Aged / Humans / Male Idioma: En Revista: Curr Probl Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Panamá Pais de publicación: Países Bajos