Efficacy of Statins for Recurrent Cardiac Ischemia in Elderly Patients

Background: With the improvement of the survival rate after acute myocardial infarction, elderly patients with cardiac ischemia are increasing. Ischemic heart disease is one of the main cause of heart failure of elderly, therefore, it is important to consider how secondary prevention for elderly patients should be managed. Methods: From January 2007 to December 2016, 140 elderly patients (age ≥ 75 years) with previous percutaneous coronary intervention underwent coronary angiography for examination of recurrent ischemia beyond the early restenosis period. Relationship between the achieved LDL-C level, incidence of late coronary events (including recurrent ischemia presenting as acute coronary syndrome [recurrent-ACS] and any late coronary revascularization), and the effectiveness of statins were evaluated. Results: During the mean follow-up period of 7.1 years, 84 patients (60%) underwent any late revascularization. Recurrent-ACS occurred in 37 cases. Kaplan-Meier curve analysis revealed that both recurrent-ACS and any late revascularization were significantly lower in patients with LDL-C 70 to <100 mg/dL than in those with LDL-C ≥ 100 mg/dL (P = .033 and P = .005, respectively). However, no such differences were noted between patients with LDL-C < 70 mg/dL and those with LDL-C 70 to <100 mg/dL. Statin use was associated with a lower incidence of recurrent-ACS (P = .005); moreover, only using statins was an independent predictor of recurrent-ACS (HR, 0.375; P = .007). Conclusion: Using statins was important for secondary prevention for elderly patients.