AHA: Discontinuing statins noninferior to continuation in older adults without known cardiovascular disease

A recent study published in the New England Journal of Medicine questions whether older adults without a history of cardiovascular disease should discontinue statin therapy for primary prevention. Conducted by Nicolas Rodondi and colleagues from the University of Bern in Switzerland, the research analyzed 1,880 participants aged 70 and older who were randomly assigned to either continue or discontinue statin therapy along with other lipid-lowering treatments.

After a two-year follow-up period, the researchers found no significant difference in the time to a first cardiovascular event between the two groups, with a small 2-week advantage in event-free survival for those who stopped statins. During the median follow-up of 103 weeks, 12.7% in the discontinuation group and 9.2% in the continuation group experienced serious cardiovascular events such as nonfatal myocardial infarction, ischemic stroke, or death.

While the discontinuation group had a slightly higher rate of serious adverse events (43.0% vs. 39.8%), the overall risk remained manageable for most people in this age group with multimorbidity and no prior cardiovascular disease. Co-author Rita F. Redberg, from the University of California, San Francisco, emphasized the need for shared decision-making between patients and healthcare professionals when considering statin discontinuation.

In conclusion, discontinuation of statins in older adults without known cardiovascular disease appears to be safe and noninferior to continuation for two-year event-free survival, but individualized decisions are crucial.