Department of Cardiology, Jefferson University Hospital, Sidney Kimmel Medical College, 227 North Broad Street, Suite 200, Philadelphia, PA, 19107, USA.
Curr Atheroscler Rep. 2024 Nov 25;27(1):11. doi: 10.1007/s11883-024-01257-9.
Although statin therapy is well established to prevent atherosclerotic vascular disease (ASCVD) events in adults 40 to 75 years of age, it is less clear whether older adults benefit from statin therapy. The purpose of this review is to summarize the current evidence and guidelines on statin use for primary and secondary prevention in older patients.
Moderate to high intensity statin therapy decreases cardiovascular event rates in older patients with or at risk for ASCVD. Cardiac biomarkers and coronary calcium scoring can identify older patients at higher ASCVD risk who may benefit from statin therapy. Age alone should not be a deterrent to statin therapy in older patients. The decision to initiate statin therapy should occur after a patient to clinician discussion based on the patient's overall ASCVD risk and weighed against other clinical factors that influence the patient's life expectancy and quality of life.
尽管他汀类药物治疗在 40-75 岁的成年人中已被证实可预防动脉粥样硬化性血管疾病（ASCVD）事件，但对于老年人是否能从他汀类药物治疗中获益尚不清楚。本综述的目的是总结目前关于他汀类药物在老年患者一级和二级预防中的应用的证据和指南。
中等强度至高强度他汀类药物治疗可降低有或有 ASCVD 风险的老年患者的心血管事件发生率。心脏生物标志物和冠状动脉钙评分可以识别 ASCVD 风险较高的老年患者，这些患者可能从他汀类药物治疗中获益。年龄本身不应成为老年患者使用他汀类药物的障碍。是否开始他汀类药物治疗应在患者与临床医生讨论后做出决定，依据是患者的整体 ASCVD 风险，并权衡影响患者预期寿命和生活质量的其他临床因素。
