European Heart Journal Advance Access originally published online on August 3, 2006
European Heart Journal 2006 27(19):2310-2316; doi:10.1093/eurheartj/ehl180
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Benefits of achieving the NCEP optional LDL-C goal among elderly patients with ACS
1 The TIMI Study Group and Cardiovascular Division, Department of Medicine, Brigham & Women's Hospital/Harvard Medical School, Boston, MA 02115, USA
2 Cardiovascular Division, Washington University School of Medicine, St Louis, MO 63110, USA
3 Nottingham Clinical Research Ltd, Isaac Newton Centre, Nottingham Science & Technology Park, Nottingham, N67 2RH, UK
4 Cardiovascular Division, Beth Israel Deaconness Medical Centre, Harvard Medical School, Boston, MA 02215, USA
Received 2 March 2006; revised 7 July 2006; accepted 14 July 2006; online publish-ahead-of-print 3 August 2006.
* Corresponding author: TIMI Study Group, 350 Longwood Avenue, First Floor, Boston, MA 02115, USA. Tel: +1 617 278 0145; fax: +1 617 734 7329. E-mail address: koshray{at}gmail.com
Aims To assess the efficacy and safety of the achievement of the NCEP goal of LDL-C <1.8 mmol/L in elderly patients with ACS.
Methods and results The relationship between LDL-C at 30 days after ACS and subsequent clinical outcomes were compared among elderly patients (aged 
70 years) vs. younger counterparts in the PROVE IT-TIMI 22 trial, using the composite endpoint of death, myocardial infarction, or unstable angina. Among 634 elderly patients, the achievement of the NCEP goal was associated with an 8% absolute and a 40% relative lower risk of events [Hazard ratio (HR) 0.60, 95% confidence interval (CI) 0.41–0.87, P=0.008] vs. corresponding benefits of 2.3 and 26% in 3150 younger patients (HR 0.74, 95% CI 0.59–0.94, P=0.013). The estimated number of events preventable among the elderly by the achievement of these goals was 80 events at 2 years for every 1000 patients at goal vs. those not at goal, compared with 23 events potentially prevented in younger patients. The incidence of major side effects among the elderly was similar to that in younger patients and did not differ with the intensity of the statin regimen.
Conclusion Among elderly ACS patients, achieving the new NCEP LDL-C optional goal as part of a secondary prevention strategy can be both as safe and effective as in younger patients.
Key Words: Elderly • NCEP • LDL-C • Clinical events • Statins
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