TY - JOUR
T1 - Effect of statins on ventricular tachyarrhythmia, cardiac arrest, and sudden cardiac death: a meta-analysis of published and unpublished evidence from randomized trials
AU - Rahimi, Kazem
AU - Majoni, William
AU - Merhi, Amal
AU - Emberson, Jonathan
PY - 2012/7/13
Y1 - 2012/7/13
N2 - Aims The effect of statin treatment on ventricular arrhythmic complications is uncertain. We sought to test whether statins reduce the risk of ventricular tachyarrhythmia, cardiac arrest, and sudden cardiac death.Methods and resultsWe searched MEDLINE, EMBASE, and CENTRAL up to October 2010. Randomized controlled trials comparing statin with no statin or comparing intensive vs. standard dose statin, with more than 100 participants and at least 6-month follow-up were considered for inclusion and relevant unpublished data obtained from the investigators. Twenty-nine trials of statin vs. control (113 568 participants) were included in the main analyses. In these trials, statin therapy did not significantly reduce the risk of ventricular tachyarrhythmia [212 vs. 209; odds ratio (OR) 1.02, 95 confidence interval (CI) 0.841.25, P = 0.87] or of cardiac arrest (82 vs. 78; OR 1.05, 95 CI 0.761.45, P = 0.84), but was associated with a significant 10 reduction in sudden cardiac death (1131 vs. 1252; OR 0.90; 95 CI 0.820.97, P = 0.01). This compared with a 22 reduction in the risk of other 'non-sudden' (mostly atherosclerotic) cardiac deaths (1235 vs. 1553; OR 0.78, 95 CI 0.710.87, P < 0.001). Results were not materially altered by inclusion of eight trials (involving 41 452 participants) of intensive vs. standard dose statin regimens.ConclusionStatins have a modest beneficial effect on sudden cardiac death. However, previous suggestions of a substantial protective effect on ventricular arrhythmic events could not be supported.
AB - Aims The effect of statin treatment on ventricular arrhythmic complications is uncertain. We sought to test whether statins reduce the risk of ventricular tachyarrhythmia, cardiac arrest, and sudden cardiac death.Methods and resultsWe searched MEDLINE, EMBASE, and CENTRAL up to October 2010. Randomized controlled trials comparing statin with no statin or comparing intensive vs. standard dose statin, with more than 100 participants and at least 6-month follow-up were considered for inclusion and relevant unpublished data obtained from the investigators. Twenty-nine trials of statin vs. control (113 568 participants) were included in the main analyses. In these trials, statin therapy did not significantly reduce the risk of ventricular tachyarrhythmia [212 vs. 209; odds ratio (OR) 1.02, 95 confidence interval (CI) 0.841.25, P = 0.87] or of cardiac arrest (82 vs. 78; OR 1.05, 95 CI 0.761.45, P = 0.84), but was associated with a significant 10 reduction in sudden cardiac death (1131 vs. 1252; OR 0.90; 95 CI 0.820.97, P = 0.01). This compared with a 22 reduction in the risk of other 'non-sudden' (mostly atherosclerotic) cardiac deaths (1235 vs. 1553; OR 0.78, 95 CI 0.710.87, P < 0.001). Results were not materially altered by inclusion of eight trials (involving 41 452 participants) of intensive vs. standard dose statin regimens.ConclusionStatins have a modest beneficial effect on sudden cardiac death. However, previous suggestions of a substantial protective effect on ventricular arrhythmic events could not be supported.
KW - Meta-analysis
KW - Statins
KW - Sudden death
KW - Ventricular arrhythmia
UR - http://www.scopus.com/inward/record.url?scp=84863641251&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehs005
DO - 10.1093/eurheartj/ehs005
M3 - Review article
VL - 33
SP - 1571
EP - 1581
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 13
ER -