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Elevated inflammatory markers predict mortality in long-term ischemic stroke-survivors: a population-based prospective study.
CONCLUSIONS: Fibrinogen and IL-6 were independent predictors of mortality in long-term stroke-survivors, whereas elevated hs-CRP predicted mortality in stroke-free subjects. Mortality risk prediction in stroke-survivors differed from that of stroke-free subjects. PMID: 27146666 [PubMed - as supplied by publisher]
Source: Aging Clinical and Experimental Research - May 3, 2016 Category: Geriatrics Authors: Frøyshov HM, Bjørnerem Å, Engstad T, Halvorsen DS Tags: Aging Clin Exp Res Source Type: research

237 Systematic Review of Fibrinogen and Risk of Recurrent Stroke and Vascular Events after Ischaemic Stroke or Transient Ischaemic Attack (TIA)
ConclusionThe prognostic value of Fibrinogen after stroke or TIA remains unclear. Standardised methods and fully-adjusted multivariable analysis are needed in future prognostic studies.
Source: Age and Ageing - September 16, 2019 Category: Geriatrics Source Type: research

Stroke severity and outcomes for octogenarians receiving statins
Abstract: Pre-exposure to 3-hydroxy-3-methylgutaryl-coenzyne A reductase inhibitors (statins) appears to improve outcomes in patients with acute ischemic stroke (AIS). Whether this extends to patients over 80 is not known. Patients ≥80 years of age with AIS were retrospectively reviewed from the stroke registry of a tertiary stroke center. Pre-admission statin use, demographics, vascular risk factors, and comorbid conditions were assessed. Primary outcomes were admission National Institutes of Health Stroke Scale (NIHSS) scores and in-hospital mortality/discharge to hospice, and secondary outcomes included subsequent int...
Source: Archives of Gerontology and Geriatrics - July 1, 2013 Category: Geriatrics Authors: Michael S. Phipps, Neer Zeevi, Ilene Staff, Gil Fortunato, George A. Kuchel, Louise D. McCullough Source Type: research

Secondary Prevention of Stroke in the Elderly: Focus on Drug Therapy
Abstract Secondary stroke prevention in the elderly in many cases requires the use of drug therapy to maximize risk factor control. However, the elderly (≥65 years) are most likely to receive care that is not evidence-based, because of concerns for adverse events. In this review, we provide evidence to the practitioner in support of the value of blood pressure control with drug therapy to decrease recurrent stroke risk. This review also highlights evidence for the importance of statin therapy in stroke prevention among the elderly. Finally, the appropriate use of antiplatelet therapy and oral anticoagulation is addressed.
Source: Drugs and Aging - September 29, 2014 Category: Geriatrics Source Type: research

Stroke Rounds: Are Oldest Patients Getting Too Many Drugs? (CME/CE)
(MedPage Today) -- Too many healthy people in their 80s and older are being treated with statins and antihypertensives for stroke prevention, according to a perspective in Evidence-Based Medicine.
Source: MedPage Today Geriatrics - February 27, 2014 Category: Geriatrics Source Type: news

Mixed Results for Low-Dose Statin in Second Stroke
(MedPage Today) -- Pravastatin didn't reduce incidence of recurrent stroke, but did offer other benefits.
Source: MedPage Today Geriatrics - February 16, 2015 Category: Geriatrics Source Type: news

Associations Between Thrombin Generation and the Risk of Cardiovascular Disease in Elderly Patients: Results From the PROSPER Study
Conclusions. We demonstrate that a delayed and decreased thrombin generation is a strong and independent predictor for stroke in elderly people at increased risk of vascular disease. However, no convincing consistent association could be demonstrated between thrombin generation and incident CHD.
Source: Journals of Gerontology Series A: Biological Sciences and Medical Sciences - July 6, 2015 Category: Geriatrics Authors: Loeffen, R., Winckers, K., Ford, I., Jukema, J. W., Robertson, M., Stott, D. J., Spronk, H. M., ten Cate, H., Lowe, G. D., on behalf of the PROSPER Study Group Tags: Research Article Source Type: research

Statins for Primary Prevention of Cardiovascular Disease in Elderly Patients: Systematic Review and Meta-Analysis
Conclusions From a risk–benefit perspective, there is a role of statins for the primary prevention of major adverse cardiovascular events in elderly patients. Further studies are needed to ascertain the benefits of statins on fatal MI, stroke and all-cause mortality.
Source: Drugs and Aging - August 6, 2015 Category: Geriatrics Source Type: research

Safety and Effectiveness of Statins for Prevention of Recurrent Myocardial Infarction in 12 156 Typical Older Patients: A Quasi-Experimental Study
Conclusions: Estimates of statin effectiveness for the prevention of recurrent myocardial infarction in patients aged 60–79 years were similar to trial results, but more evidence is needed in the older group. There may be an excess of falls and fractures in very old patients, which deserves further investigation.
Source: Journals of Gerontology Series A: Biological Sciences and Medical Sciences - January 12, 2017 Category: Geriatrics Authors: Ble, A., Hughes, P. M., Delgado, J., Masoli, J. A., Bowman, K., Zirk-Sadowski, J., Mujica Mota, R. E., Henley, W. E., Melzer, D. Tags: Research Article Source Type: research

The Timing Hypothesis and Hormone Replacement Therapy: A Paradigm Shift in the Primary Prevention of Coronary Heart Disease in Women. Part 2: Comparative Risks
A major misperception concerning postmenopausal hormone replacement therapy (HRT) is that the associated risks are large in magnitude and unique to HRT, but over the past 10 years, sufficient data have accumulated so that the magnitude and perspective of risks associated with the primary coronary heart disease prevention therapies of statins, aspirin, and postmenopausal HRT have become more fully defined. Review of randomized controlled trials indicates that the risks of primary prevention therapies and other medications commonly used in women's health are of similar type and magnitude, with the majority of these risks ca...
Source: Journal of the American Geriatrics Society - May 20, 2013 Category: Geriatrics Authors: Howard N. Hodis, Wendy J. Mack Tags: Updates on Aging Source Type: research

CardioBuzz: Prevention for Octogenarians
(MedPage Today) -- An article by a British physician specializing in geriatric medicine stated that the oldest patients -- those 80 and older -- are being too aggressively treated with statins and antihypertensives for stroke prevention. U.S. cardiologists respond.
Source: MedPage Today Geriatrics - February 28, 2014 Category: Geriatrics Source Type: news

Statin Discontinuation in Nursing Home Residents with Advanced Dementia
ConclusionMost NH residents who use statins at the time of progression to advanced dementia continue use in follow‐up.
Source: Journal of the American Geriatrics Society - November 4, 2014 Category: Geriatrics Authors: Jennifer Tjia, Sarah L. Cutrona, Daniel Peterson, George Reed, Susan E. Andrade, Susan L. Mitchell Tags: Clinical Investigations Source Type: research

Statins Provide Less Benefit in Populations with High Noncardiovascular Mortality Risk: Meta‐Regression of Randomized Controlled Trials
ConclusionBenefits of statins may depend on the non‐CV mortality risk of the treated population. This should be confirmed using individual‐level data.
Source: Journal of the American Geriatrics Society - July 14, 2015 Category: Geriatrics Authors: Caroline A. Kim, Dae Hyun Kim Tags: Brief Reports Source Type: research

Statins for Primary Prevention of Cardiovascular Events and Mortality in Older Men
ConclusionsStatin use was associated with a significant lower risk of mortality in older male physicians ≥70 and a nonsignificant lower risk of CVD events. Results did not change in those who were >76 years at baseline or according to functional status. There was a suggestion that those with elevated total cholesterol may benefit. Further work is needed to determine which older individuals will benefit from statins as primary prevention.
Source: Journal of the American Geriatrics Society - September 1, 2017 Category: Geriatrics Authors: Ariela R. Orkaby, J. Michael Gaziano, Luc Djousse, Jane A. Driver Tags: Clinical Investigation Source Type: research

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