BC 081 – Atorvastatine, événements cardiovasculaires et survie sans invalidité chez les personnes âgées (étude STAREE)

Épisode de BaladoCritique - club de lecture médical par Dr Luc Lanthier et collaborateurs · 29 octobre 2026 · 34 min

Dans cette 81e baladodiffusion, les Drs Luc Lanthier et Pierre-Nicolas Perron discutent du traitement de la dyslipidémie chez les personnes âgées avec l’étude STAREE, en plus de réviser la littérature médicale de septembre 2026.

Quiz clinique (1 min 19), présentation principale (1 min 40), critique (19 min 50), retour sur le cas clinique (26 min 28), autres articles (28 min 48), réponse au quiz clinique (31 min 04).

Référence principale :

Zoungas S, Wolfe R, Moran C, Nicholls SJ, Cloud GC, Reid CM, et al; STAREE Investigators. Atorvastatin, Cardiovascular Events, and Disability-free Survival in Older Adults. N Engl J Med. 2026;395(13):1259-1272. PubMed PMID: 42670961.

Articles associés :

Mortensen MB. Statins in Older Adults – Evidence at Last. N Engl J Med. 2026;395(13):1327-8. PubMed PMID: 42814932.

Gencer B, Marston NA, Im K, Cannon CP, Sever P, Keech A, et al. Efficacy and safety of lowering LDL cholesterol in older patients: a systematic review and meta-analysis of randomised controlled trials. Lancet. 2020;396(10263):1637-43. PubMed PMID: 33186535.

Mortensen MB, Nordestgaard BG. Elevated LDL cholesterol and increased risk of myocardial infarction and atherosclerotic cardiovascular disease in individuals aged 70-100 years: a contemporary primary prevention cohort. Lancet. 2020;396(10263):1644-52. PubMed PMID: 33186534.

Cholesterol Treatment Trialists Collaboration. Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. Lancet. 2019;393(10170):407-15. PubMed PMID: 30712900.

Orkaby AR, Driver JA, Ho YL, Lu B, Costa L, Honerlaw J, et al. Association of Statin Use With All-Cause and Cardiovascular Mortality in US Veterans 75 Years and Older. JAMA. 2020;324(1):68-78. PubMed PMID: 32633800.

Yourman LC, Cenzer IS, Boscardin WJ, Nguyen BT, Smith AK, Schonberg MA, et al. Evaluation of Time to Benefit of Statins for the Primary Prevention of Cardiovascular Events in Adults Aged 50 to 75 Years: A Meta-analysis. JAMA Intern Med. 2021;181(2):179-85. PubMed PMID: 33196766.

Shepherd J, Blauw GJ, Murphy MB, Bollen EL, Buckley BM, Cobbe Smet al; PROSPER study group. PROspective Study of Pravastatin in the Elderly at Risk. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet. 2002;360(9346):1623-30. PubMed PMID: 12457784.

Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;153(17):e1154-e1276. PubMed PMID: 41824552.

Bonnet F, Poulizac P, Rousselot N, Couffinhal T, Galli G, Berdai D, et al. Discontinuation of statins for primary prevention of atherosclerotic cardiovascular disease in adults aged 75 years or older (SAGA/SITE): a multicentre, open-label, pragmatic, non-inferiority randomised trial. Lancet Healthy Longev. 2026;7(7):100884. PubMed PMID: 42580354.

https://deprescribing.org/wp-content/uploads/2025/10/Statin-Deprescribing-Algorithm.pdf

Table de survie actuarielle (Canada) : https://www150.statcan.gc.ca/n1/pub/84-537-x/84-537-x2024001-fra.htm

Autres articles d’intérêt récent :

Kim D, Lee YS, Shim J, Yu HT, Park J, Park JK, et al. Anticoagulation for Atrial Fibrillation with Intermediate Stroke Risk. N Engl J Med. 2026;395(12):1155-65. PubMed PMID: 42663303.

Silvain J, Choi KH, Monguillon V, Kang D, Cayla G, Kim W, et al. Discontinuation of beta-blockers in stable patients with previous myocardial infarction, preserved left ventricular ejection fraction, and no heart failure: a pooled analysis of individual patient data. Lancet. 2026;408(10560):1093-102. PubMed PMID: 42669300.

Guides de pratique :

Mills NL, Newby LK, Zaman S, Almahmeed WA, Bucciarelli-Ducci C, Colvin MM, et al. Fifth Universal Definition of Myocardial Infarction (2026). J Am Coll Cardiol. 2026;88(11):1314-68. PubMed PMID: 42663357.

Thompson A, Fleischmann KE, Smilowitz NR, de Las Fuentes L, Mukherjee D, et al. 2026 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;154(13):e413-e504. PubMed PMID: 42804570.

Fischer M, Vaughn BP, Peery AF, Kelly CR. AGA Clinical Practice Update on Management of Clostridioides difficile Infection in Adults: Expert Review. Clin Gastroenterol Hepatol. 2026;24(9):2359-69. PubMed PMID: 42383946.

Référence du quiz clinique :

https://ourworldindata.org/deadliest-animals

https://en.wikipedia.org/wiki/List_of_animals_deadliest_to_humans

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