Optimal lipid-lowering therapy (LLT) intensity lacks clear evidence for post-myocardial infarction (MI) patients over 80 years. In a study published in the American Journal of Preventive Cardiology, the researchers compared low- versus moderate-to-high-intensity LLT effects on mortality using real-world data.

This analysis drew from Tianjin Health and Medical Data Platform for MI patients aged >80 years. Groups split by LLT intensity: low (n=3559) vs moderate-to-high (n=8026). Primary outcome was all-cause mortality; secondary included CV mortality, recurrent MI, stroke. Multivariable Cox models calculated HRs and 95% CIs. Charlson Comorbidity Index (CCI) stratified analyses.

Over median 3-year follow-up, mortality rates were 29.1% (low-intensity) vs 21.4% (moderate-to-high). Moderate-to-high LLT tied to lower all-cause mortality (HR 0.81, 95% CI 0.75-0.88) and CV mortality (HR 0.77, 95% CI 0.70-0.86). Benefits seen mainly in CCI ≤4 subgroup (HR 0.79 all-cause, 0.74 CV mortality).

In this retrospective cohort, moderate-to-high-intensity LLT associated with reduced mortality risk in lower-burden elderly post-MI patients. Findings highlight comorbidity-specific patterns, pending randomized trials for confirmation.