Effect of Statins on Ventricular Tachyarrhythmia, Cardiac Arrest, and Sudden Cardiac Death: A Meta-Analysis of Published and Unpublished Evidence From Randomized Trials
Do statins prevent malignant ventricular tachyarrhythmias (VTs)?
This was a meta-analysis of randomized trials that compared statins to a placebo or usual care (29 trials, 113,568 subjects), or that compared different intensities of statin therapy (8 trials, 41,452 subjects). Unpublished data on VTs were obtained whenever feasible directly from the investigators.
Data on VTs, cardiac arrest, and sudden cardiac death (SCD) were available in 18, 12, and 30 trials, respectively. Statins did not significantly reduce the risk of VTs or cardiac arrest. Statin therapy was associated with a significant 11% reduction in the risk of SCD.
The authors concluded that statins modestly reduce the risk of SCD, but do not prevent VTs or cardiac arrest.
The results of this meta-analysis suggest that the mechanism by which statins lower the risk of SCD is by prevention of acute coronary events, not by a primary antiarrhythmic effect. In contrast, prior studies, most of which were nonrandomized, reported that stains reduce the risk of VTs by approximately 30%. A strength of the present study is that only randomized trials were analyzed. Furthermore, much of the data were previously unpublished and obtained directly from the investigators, eliminating publication bias as a confounding factor.
Keywords: Hydroxymethylglutaryl-CoA Reductase Inhibitors, Death, Sudden, Cardiac
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