STAREE
STAtin Therapy for Reducing Events in the Elderly
Doente / População Intervenção / Exposição Comparação Desfecho
In 9,971 healthy adults aged 70 years or over, atorvastatin 40 mg improved one of two co-primary outcomes — disability-free survival and major cardiovascular events — compared with placebo.
N
9971doentes
Desenho
Double-blind, placebo-controlled RCT, 1:1, recruited through Australian general practice, average follow-up about 6 years planned, time-to-first-event analyses for each co-primary endpoint
Desfecho
Co-primary — (1) disability-free survival, defined as survival free of dementia and persistent physical disability; (2) major cardiovascular events (cardiovascular death, non-fatal myocardial infarction or stroke; registry definition also lists coronary revascularisation)
Relevância
1Define a prática — o ensaio em que a diretriz assenta.
ResultadoMajor cardiovascular events 6.0% vs 8.3% over a median 5.9 years (HR 0.70, 95% CI 0.61-0.82; P < 0.001). The other co-primary, disability-free survival, was unchanged: 12.8% vs 13.6% (HR 0.94, 95% CI 0.84-1.05; P = 0.25). Muscle, liver and diabetes-related adverse events were more common with atorvastatin; serious adverse events 2.7% in both arms.
Zoungas S, et al. N Engl J Med. 2026; published online 28 August. 10.1056/nejmoa2607314
Discussão e crítica
The trial general practice has been waiting for: a statin started after 70, in people without cardiovascular disease, diabetes or dementia. Cardiovascular events fall by 30% relative and 2.3 percentage points absolute over six years, roughly 43 people treated for one event avoided. The endpoint older patients are usually promised — years free of dementia and disability — did not move, and the entrants were healthy volunteers rather than the frail, comorbid 80-year-olds in whom the question is hardest.