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COMMENTS AND OPINIONS
Continuation of Statin Treatment and Mortality: A Note of Caution on Excessive Benefits—Reply
Varda Shalev, MD;
Gabriel Chodick, PhD
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In reply
In response to the concerns raised by Golumb and Koperski, we agree that lower cognitive function could have confounded the association between persistence with statin therapy and mortality; however, this potential threat does not agree with the fact that the lowest protective effects of statins in our study were calculated among elderly patients, in whom differences in cognitive function would have been expected to be the largest. Also, the similar relative risk reduction in primary prevention and secondary prevention patients and the recent findings that persistence with statin use may increase cognitive impairment among elderly patients1 do not support the concerns of Golomb and Koperski.
Also, Golomb and Koperski point out that lower persistence with statin therapy could be linked with more frequent adverse effects and in turn with higher risk of death, particularly among patients treated with high-efficacy statins. However, in . . . [Full Text of this Article]
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