Questioning Medicine

Orkaby AR et al. Association of statin use with all-cause and cardiovascular mortality in US veterans 75 years and older. JAMA 2020 Jul 7; 324:68. (https://doi.org/10.1001/jama.2020.7848) retrospective cohort study of about 327,000 patients (age, ≥75; mean age, 81; mostly white men) without prior statin use, without a prior cardiovascular event; in total 326K vets that were 75yr old and older and had never had a cardiovascular event those started on statin therapy did better!!!all-cause mortality was 78.7 per 1000 person years in those started on a statin and 98.2 per 1000 person-years in those not a on a statin. BUT devel in the details-- they say they looked at 7.2 million vets- then once you took out the people that had prior statin exposure, and removed the people with missing data, and then excluded those with a prior cardiovascular event, and threw out those individuals who died in the first 150 days -- you then get the 326K. and of those about 57k got a statin prescription and 269K never got a statin p