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Newest story: 8 Nov 2026

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NEJM · 7 Nov 2026 · Supplements / medicine

In 1,880 older adults already taking a statin, a trial found stopping was noninferior to continuing at 2 years, with more events in the stop group

NEJM published a randomized trial on 7 November 2026. Rodondi and colleagues assigned 1,880 older adults who were already taking a statin for primary prevention, had at least two chronic conditions, and had no known cardiovascular disease. Mean age was 77.5 years, and 46.9 percent were women. 938 were assigned to stop the statin and 942 to continue. At 2 years, the difference in restricted mean event-free time was -2.0 weeks (95 percent CI -3.7 to -0.3), which met the trial noninferiority test (P < 0.001). Over a median of 103 weeks, 119 people (12.7 percent) who stopped and 87 people (9.2 percent) who continued had a primary-outcome event, a major cardiovascular event or death. Serious adverse events were 43.0 percent versus 39.8 percent. The trial conclusion is that stopping was noninferior to continuing for that outcome at 2 years. The abstract used here does not give a hazard ratio. This card does not say anyone should stop a statin. That decision stays with the clinician who prescribed it. DOI 10.1056/NEJMoa2606634. Not medical advice. Not a substitute for a prescribed medicine. Off-label prescription use is clinician-only. VitaLonga does not diagnose, treat, or cure disease. Never start, stop, or replace a prescription with a supplement on the basis of a headline.

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JAMA · 7 Nov 2026 · Research

In 5,179 people with moderate or severe ischemia, an invasive strategy did not lower 11-year mortality

JAMA published an extended follow-up of a randomized trial on 7 November 2026. Hochman, Anthopolos, and colleagues report ISCHEMIA-EXTEND. The original trial enrolled 5,179 people with moderate or severe ischemia, a median age of 64 years (IQR 58 to 70), 23 percent women, 42 percent with diabetes, and a median ejection fraction of 60 percent. Entry required an ejection fraction of at least 35 percent, and excluded left main coronary disease, unacceptable angina, and a recent acute coronary syndrome. People were randomized at 320 sites in 37 countries to an invasive strategy (guideline-directed medical therapy plus angiography and revascularization when indicated) or a conservative strategy (guideline-directed medical therapy, with an invasive procedure only if that therapy failed). Follow-up ran through December 2025. Median follow-up was 9 years. There were 1,071 deaths (782 of them in the extension): 672 cardiovascular, 359 not cardiovascular, and 40 unclassified. At 11 years, all-cause mortality was 25.8 percent with the invasive strategy and 26.9 percent with the conservative strategy, a difference of -1.0 percentage points (95 percent CI -4.2 to 2.1). The adjusted hazard ratio was 0.97 (0.86 to 1.09). A Bayesian estimate put the probability of more than a 1 percentage point survival benefit at 18 percent. Cardiovascular mortality was 15.8 percent versus 17.1 percent, difference -1.4 percentage points (-4.0 to 1.3), adjusted hazard ratio 0.88 (0.75 to 1.02). Mortality that was not cardiovascular was 9.1 percent versus 8.1 percent, difference +1.0 percentage points (-0.9 to 2.9), adjusted hazard ratio 1.18 (0.96 to 1.45). The restricted mean survival difference was 14 days (-41 to 70). Registration NCT04894877. DOI 10.1001/jama.2026.20375. Not medical advice.

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GeroScience · 7 Nov 2026 · Aging

In 251 hospitalized older adults, a few Torque teno virus species lined up with frailty and cognitive impairment, and not with short-term mortality after adjustment

GeroScience published an observational study online on 7 November 2026. Federica Novazzi, Carlo Fortunato, Robertina Giacconi, and colleagues studied 251 hospitalized older adults. They sequenced the circulating anellovirome, the mix of Torque teno viruses in the blood, with amplicon-based whole-genome sequencing. Lower species evenness lined up with 1-year mortality (p = 0.013, false-discovery rate 0.052). Species composition accounted for less than 1 percent of the variance (PERMANOVA Ruzicka R2 0.0079, p = 0.021, false-discovery rate 0.035; Bray-Curtis R2 0.0082, p = 0.035, false-discovery rate 0.035). After multivariable adjustment, TTV19 was enriched in people with 1-year mortality, 3-year mortality, frailty, and cognitive impairment, and TTV9 was enriched in people with frailty. A bootstrap estimate put the TTV19 link with cognitive impairment at a log fold-change of 2.39 (95 percent CI 0.59 to 5.43) and the TTV9 link with frailty at 2.26 (95 percent CI 0.11 to 9.86). In Cox models, TTV19 abundance was not significantly associated with 1-year or 3-year mortality. A nominal link with seven-year mortality (hazard ratio 1.10, 95 percent CI 1.01 to 1.19) did not pass a multiple-testing correction. TTV19 log-abundance was nominally associated with GrimAge epigenetic age acceleration (p = 0.024, false-discovery rate 0.072) and with DNA-methylation estimates of inflammatory and vascular markers. The authors say this viral mix mainly reflects systemic vulnerability in late life, and that a few species are candidate correlates that still need outside confirmation. Support came from the Italian Ministry of Health (MAD-2022-12376334). The pages used here do not give a sex split. This is not a test to order. DOI 10.1007/s11357-026-02644-7. Not medical advice.

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