Statin therapy significantly reduces risk of ventricular tachyarrhythmias in patients with an implantable cardioverter defibrillator

Am J Ther. 2012 Jul;19(4):261-8. doi: 10.1097/MJT.0b013e3181f94c38.

Abstract

A few observational studies have shown the protective effect of statins on preventing ventricular tachycardia/ventricular fibrillation (VT/VF). However, the disparate study results prompt further exploration of this concept. We performed a meta-analysis to assess whether statin therapy is associated with a decrease in the incidence or recurrence of VT/VF in patients with an implantable cardioverter-defibrillator (ICD).The MEDLINE(®) and Cochrane databases were searched from 1980 to July 2009 for studies examining the effect of statins on VT/VF in recipients of ICDs. We retrieved all prospective cohort studies that examined this association. The endpoint was defined as appropriate ICD therapy for VT/VF. The quality of individual studies was assessed using the Newcastle Ottawa Scale.Seven prospective cohort studies met our inclusion criteria with a total of 2278 patients with a mean follow-up of 19.7 months. Pooled analysis of the eligible studies revealed that statin therapy was associated with a 45% reduction in the risk of developing VT/VF in recepients of ICDs [pooled odds ratio (pOR): 0.55; 95% confidence interval: 0.34-0.90; heterogeneity I(2) = 81%, P = 0.02]. In a subgroup analysis, the magnitude of the risk reduction in patients with ischemic cardiomyopathy was 54% (pOR: 0.46, P = 0.05). Sensitivity analysis including studies with higher methodological qualities alone showed a significant protective effect (pOR: 0.48, P = 0.01). There was no evidence of publication bias in the analysis.Our meta-analysis suggests an association between the use of statin and a reduction in the VT/VF occurrence in recipients of ICDs, mainly in patients with ischemic cardiomyopathy.

Publication types

  • Meta-Analysis

MeSH terms

  • Cohort Studies
  • Defibrillators, Implantable*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Incidence
  • Myocardial Ischemia / complications
  • Recurrence
  • Risk
  • Risk Factors
  • Tachycardia, Ventricular / epidemiology
  • Tachycardia, Ventricular / prevention & control*
  • Ventricular Fibrillation / epidemiology
  • Ventricular Fibrillation / prevention & control*

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors