Tratamiento con estatinas en pacientes dislipidémicos mayores de 75 años, en prevención primaria / Statin treatment as primary prevention in dyslipidaemic patients older than 75 years

OBJETIVOS: Determinar posibles diferencias en la incidencia de eventos cardiovasculares entre pacientes dislipidémicos mayores de 75 años tratados con estatinas respecto a aquellos que no las toman, en prevención primaria. MATERIAL Y MÉTODOS: Se realiza un estudio de cohortes retrospectivo en mayores de 75 años con dislipidemia en un centro de salud, entre los años 2005 y 2015. Se estudiaron 329 pacientes (182 en tratamiento con estatinas y 147 sin tratamiento hipolipidemiante) que cumplían los criterios de inclusión (paciente de 75 años o más, en tratamiento con estatinas durante al menos 3 años o no haber realizado ningún tratamiento hipolipidemiante, y en prevención primaria). Las variables de estudio fueron todas aquellas que las últimas guías de riesgo cardiovascular establecen como factor de riesgo, siendo «evento cardiovascular» la variable dependiente. Se realizó un análisis descriptivo e inferencial para variables cuantitativas y cualitativas, así como un análisis multivariante mediante regresión logística binaria. RESULTADOS: La incidencia de eventos cardiovasculares en pacientes sin tratamiento con estatinas es de un 15,93% (IC 95% 11,15-21,80), y de un 37,42% (IC 95% 29,87-45,45) en aquellos que sí las tomaban (p < 0,001), con un RR de 2,35 (IC 95% 1,58-3,48). CONCLUSIONES: Existen diferencias estadísticamente significativas con un aumento en la incidencia de eventos cardiovasculares en pacientes que toman estatinas, respecto a los que no. Se plantea si actualmente se está dando la importancia real a las cifras de colesterol en este perfil de pacientes, así como si la indicación de prescripción de estatinas en mayores de 75 años es adecuada en prevención primaria

OBJECTIVES: To determine possible differences in the incidence of cardiovascular events between dyslipidaemia patients older than 75 years treated with statins compared to those not treated with them, as primary prevention. MATERIAL AND METHODS: A retrospective cohort study was conducted in patients older than 75 years with dyslipidaemia in a health centre, between 2005 and 2015. The study included 329 patients (182 on treatment with statins and 147 with no lipid-lowering treatment) who met the inclusion criteria (patients older than 75 years, on treatment with statins for at least 3 years, or to have not had any lipid lowering treatment and as primary prevention). The study variables were all those considered as a risk factor in the latest cardiovascular risk guidelines, and the dependent variable was "cardiovascular event". A descriptive and inferential analysis was carried out for quantitative and qualitative variables, as well as a multivariate analysis using binary logistic regression. RESULTS: The incidence of cardiovascular events in patients without treatment with statins was 15.93% (95% CI 11.15-21.80), and 37.42% (95% CI 29.87-45.45) in those that were taking them (P<.001). The RR was 2.35 (95% CI 1.58-3.48). CONCLUSIONS: There are statistically significant differences, with an increase in the incidence of cardiovascular events in patients taking statins, compared to those who do not. It is currently considered whether real importance is being given to cholesterol levels in this patient group, as well as whether the prescription of statins in patients older than 75 years is suitable in primary prevention

[Statin treatment as primary prevention in dyslipidaemic patients older than 75 years]. / Tratamiento con estatinas en pacientes dislipidémicos mayores de 75 años, en prevención primaria.

OBJECTIVES: To determine possible differences in the incidence of cardiovascular events between dyslipidaemia patients older than 75 years treated with statins compared to those not treated with them, as primary prevention. MATERIAL AND METHODS: A retrospective cohort study was conducted in patients older than 75 years with dyslipidaemia in a health centre, between 2005 and 2015. The study included 329 patients (182 on treatment with statins and 147 with no lipid-lowering treatment) who met the inclusion criteria (patients older than 75 years, on treatment with statins for at least 3 years, or to have not had any lipid lowering treatment and as primary prevention). The study variables were all those considered as a risk factor in the latest cardiovascular risk guidelines, and the dependent variable was "cardiovascular event". A descriptive and inferential analysis was carried out for quantitative and qualitative variables, as well as a multivariate analysis using binary logistic regression. RESULTS: The incidence of cardiovascular events in patients without treatment with statins was 15.93% (95% CI 11.15-21.80), and 37.42% (95% CI 29.87-45.45) in those that were taking them (P<.001). The RR was 2.35 (95% CI 1.58-3.48). CONCLUSIONS: There are statistically significant differences, with an increase in the incidence of cardiovascular events in patients taking statins, compared to those who do not. It is currently considered whether real importance is being given to cholesterol levels in this patient group, as well as whether the prescription of statins in patients older than 75 years is suitable in primary prevention.