Few trials have assessed the efficacy of statins for the primary or secondary prevention of cardiovascular disease in type-2 diabetic patients, let alone older patients, according to researchers from the Collaborative Atorvastatin Diabetes Study (CARDS). Some trials have found a statistically significant benefit, but others have not, perhaps because the numbers of enrolled patients were too small.
In view of these findings, a post hoc analysis of data from CARDS was conducted to compare statin therapy in 1,129 patients 65 to 75 years of age and in 1,709 younger patients. Treatment with atorvastatin 10 mg/ day reduced the relative risk of a first major cardiovascular event by 38% in older patients and by 37% in younger patients. The risk of a stroke was nearly halved. Two of 572 (0.3%) older patients who were taking atorvastatin had fatal heart attacks, compared with 12 of 557 (2.2%) receiving placebo.
One patient in the over-65 age group taking atorvastatin had a fatal stroke, and 12 patients had nonfatal strokes, compared with four patients who died and 17 placebo patients with nonfatal strokes. Treatment was well tolerated in both groups, even with the high use of concomitant drugs in the older patients.