OBJECTIVES: Elderly patients are less likely to receive statin therapy because 
of concerns about their side-effects. However, 80% of deaths related to coronary 
heart disease occur in patients above the age of 65 years. This study evaluated 
the potential benefit of early administration of statins in elderly patients 
presenting with an acute coronary syndrome.
METHODS: This was a prospective cohort study of 774 elderly patients (>65 years) 
with acute coronary syndrome. The patients were divided into two groups. The 
first group, consisting of 611 patients, received statins within the first 24 
hours of admission, while the second group, consisting of 163 patients, received 
statins after the first 24 hours. The end points studied included death, heart 
failure/pulmonary edema, stroke and recurrent myocardial infarction during 
hospitalization.
RESULTS: Multivariable logistic regression analysis, adjusting for baseline 
demographics, co-morbidities and chronic statin therapy, showed that the 
occurrence of heart failure/pulmonary edema during hospitalization was 
relatively lower among those who received statins within 24 hours of admission 
(odds ratio: 0.5, 95% CI: 0.27-0.94, p=0.03). The C statistic for the model was 
0.79.
CONCLUSION: Elderly patients presenting with acute coronary syndrome seem to 
benefit from early statin therapy, and have significantly lower rates of heart 
failure and pulmonary edema than those who are administered statins at a later 
stage.