Evidence-based Cardiovascular Medicine (2006) 10, 11–12 Evidence-based CARDIOVASCULAR MEDICINE CHOLESTEROL Fluvastatin may be similarly effective in older and younger people $ Hallvard Holdaas, Debbie Singh Background Statin therapy reduces the incidence of major coronary events, in both middle and old age, by about one quarter per mmol/L reduction in LDL- cholesterol. 1 Studies suggest that pravastatin 2,3 and simvastatin 4 have a cardioprotective lipid lowering effect in the elderly. However, little is known about the potential of fluvastatin for people older than 65 years. Objective Bruckert and colleagues compared the efficacy and safety of fluvastatin in people older and younger than 65 years. The primary endpoint was major adverse cardiovascular events. Method The authors pooled data from 30 completed clinical trials in people younger than 65 ðn ¼ 8; 037Þ and people older than 65 years ðn ¼ 3; 717Þ: The search method was not reported. Double-blind randomised, placebo or fluvastatin- controlled trials with at least six weeks of active treatment and daily fluvastatin doses of 20 mg, 40 mg, and 80 mg were included. Twenty-four trials were placebo controlled. The other six trials assessed multiple fluvastatin doses or compared immediate and extended release formulations. Only participants who received at least one dose were included in the pooled analysis. Main results In people aged 65 years or more, fluvastatin was associated with lipid changes equivalent to or slightly better than in younger people. Fluvastatin was associated with fewer major adverse cardiac events and increased time to first major cardiac event in older people. Adverse events were similar between those receiving placebo and fluvastatin and between different age groups. Authors’ conclusions The authors concluded that fluvastatin lowered cholesterol levels and reduced cardiovascular events in older people as effectively as in younger people. Overall quality ARTICLE IN PRESS www.elsevier.com/locate/ebcm practical use method quality topic importance Poor Fair Good Excellent 1361-2611/$ - see front matter & 2006 Elsevier Ltd. All rights reserved. doi:10.1016/j.ebcm.2006.01.001 $ Abstracted from Bruckert E, Verpilleux MP, Dejager S, Isaacsohn J. Comparison of efficacy and safety assessment of fluvastatin in patients o65 years versus Z 65 years of age. Am J Cardiol 2005; 96(8): 1142–8.