Does Age Modify Effectiveness of Statin Therapy in Coronary Artery Disease?
Authors: Rodney A. Hayward
Journal: Annals of Internal Medicine (2010)

Letters15 June 2010Does Age Modify Effectiveness of Statin Therapy in Coronary Artery Disease?Rodney A. Hayward, MDRodney A. Hayward, MDFrom University of Michigan Medical School, Ann Arbor, MI 48109.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-12-201006150-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the comments from Drs. Pletcher and Coxson but respectfully disagree with their interpretation of the literature.The meta-analysis by Lewington and colleagues (1) is not very relevant to our study. It combined observational studies of varying quality and completeness that were not treatment trials and thus do not reflect the effect of therapy on outcomes. Furthermore, these studies examined only mortality and did not include other cardiovascular events.We are also confused about why Drs. Pletcher and Coxson refer to relative risks associated with total cholesterol level, which is a relatively poor predictor of ischemic heart ...References1. Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J, et al; Prospective Studies Collaboration. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet. 2007;370:1829-39. [PMID: 18061058] CrossrefMedlineGoogle Scholar2. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al; Cholesterol Treatment Trialists' (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267-78. [PMID: 16214597] CrossrefMedlineGoogle Scholar3. NHS National Institute for Health and Clinical Excellence. Statins for the prevention of cardiovascular events in patients at increased risk of developing cardiovascular disease or those with established cardiovascular disease. Accessed at www.nice.org.uk/TA094 on 3 May 2010. Google Scholar4. Pletcher MJ, Lazar L, Bibbins-Domingo K, Moran A, Rodondi N, Coxson P, et al. Comparing impact and cost-effectiveness of primary prevention strategies for lipid-lowering. Ann Intern Med. 2009;150:243-54. [PMID: 19221376] LinkGoogle Scholar5. Zulman DM, Vijan S, Omenn GS, Hayward RA. The relative merits of population-based and targeted prevention strategies. Milbank Q. 2008;86:557-80. [PMID: 19120980] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Rodney A. Hayward, MDAffiliations: From University of Michigan Medical School, Ann Arbor, MI 48109.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparing Impact and Cost-Effectiveness of Primary Prevention Strategies for Lipid-Lowering Mark J. Pletcher , Lawrence Lazar , Kirsten Bibbins-Domingo , Andrew Moran , Nicolas Rodondi , Pamela Coxson , James Lightwood , Lawrence Williams , and Lee Goldman Optimizing Statin Treatment for Primary Prevention of Coronary Artery Disease Rodney A. Hayward , Harlan M. Krumholz , Donna M. Zulman , Justin W. Timbie , and Sandeep Vijan Does Age Modify Effectiveness of Statin Therapy in Coronary Artery Disease? Mark J. Pletcher and Pamela G. Coxson Metrics 15 June 2010Volume 152, Issue 12Page: 825-826KeywordsCholesterolLongitudinal studiesLow density lipoproteinMortalityObservational studiesRelative riskRisk managementStable coronary artery diseaseStatinsVascular diseases ePublished: 15 June 2010 Issue Published: 15 June 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...