医学
他汀类
内科学
荟萃分析
前瞻性队列研究
阿托伐他汀
高脂血症
糖尿病
优势比
物理疗法
内分泌学
作者
Avilash Mondal,Aobo Li,Samuel Edusa,Anurag Gogineni,Siddharth Karipineni,Salma Abdelhafez,Santosh Dheeraj Nalluri,Gautham Gosh Meka,Jerrin Bawa,Srikanth Puli,Vikramaditya Samala Venkata,Ankit Vyas,Akhil Jain,Rupak Desai
标识
DOI:10.1016/j.cpcardiol.2023.102038
摘要
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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