Effect of statins on ventricular tachyarrhythmia, cardiac arrest, and sudden cardiac death

a meta-analysis of published and unpublished evidence from randomized trials.

K. Rahimi, Sandawana William Majoni, A Merhi , Joanthan Emberson

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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 results: We 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dose statin, with more than 100 participants and at least 6-month follow-up were considered for inclusion and relevant unpublished data obtained from the investigators.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) 0.84–1.25, P = 0.87] or of cardiac arrest (82 vs. 78; OR = 1.05, 95% CI 0.76–1.45, P = 0.84), but was associated with a significant 10% reduction in sudden cardiac death (1131 vs. 1252; OR = 0.90; 95% CI 0.82–0.97, 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 0.71–0.87, P < 0.001). Results were not materially altered by inclusion of eight trials (involving 41 452 participants) of intensive vs. standard dose statin regimens.
Conclusion: Statins 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.
Original languageEnglish
Pages (from-to)1571-1581
Number of pages11
JournalEuropean Heart Journal
Volume33
Issue number13
DOIs
Publication statusPublished - 2012
Externally publishedYes

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Sudden Cardiac Death
Heart Arrest
Tachycardia
Meta-Analysis
Odds Ratio
Confidence Intervals
Risk Reduction Behavior
MEDLINE
Randomized Controlled Trials
Research Personnel

Cite this

@article{7adf5dc462b54f13a7364f4adfcc5a69,
title = "Effect of statins on ventricular tachyarrhythmia, cardiac arrest, and sudden cardiac death: a meta-analysis of published and unpublished evidence from randomized trials.",
abstract = "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 results: We 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) 0.84–1.25, P = 0.87] or of cardiac arrest (82 vs. 78; OR = 1.05, 95{\%} CI 0.76–1.45, P = 0.84), but was associated with a significant 10{\%} reduction in sudden cardiac death (1131 vs. 1252; OR = 0.90; 95{\%} CI 0.82–0.97, 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 0.71–0.87, P < 0.001). Results were not materially altered by inclusion of eight trials (involving 41 452 participants) of intensive vs. standard dose statin regimens.Conclusion: Statins 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.",
author = "K. Rahimi and Majoni, {Sandawana William} and A Merhi and Joanthan Emberson",
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Effect of statins on ventricular tachyarrhythmia, cardiac arrest, and sudden cardiac death : a meta-analysis of published and unpublished evidence from randomized trials. / Rahimi, K.; Majoni, Sandawana William; Merhi , A; Emberson, Joanthan.

In: European Heart Journal, Vol. 33, No. 13, 2012, p. 1571-1581.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Effect of statins on ventricular tachyarrhythmia, cardiac arrest, and sudden cardiac death

T2 - a meta-analysis of published and unpublished evidence from randomized trials.

AU - Rahimi, K.

AU - Majoni, Sandawana William

AU - Merhi , A

AU - Emberson, Joanthan

PY - 2012

Y1 - 2012

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 results: We 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) 0.84–1.25, P = 0.87] or of cardiac arrest (82 vs. 78; OR = 1.05, 95% CI 0.76–1.45, P = 0.84), but was associated with a significant 10% reduction in sudden cardiac death (1131 vs. 1252; OR = 0.90; 95% CI 0.82–0.97, 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 0.71–0.87, P < 0.001). Results were not materially altered by inclusion of eight trials (involving 41 452 participants) of intensive vs. standard dose statin regimens.Conclusion: Statins 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 results: We 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) 0.84–1.25, P = 0.87] or of cardiac arrest (82 vs. 78; OR = 1.05, 95% CI 0.76–1.45, P = 0.84), but was associated with a significant 10% reduction in sudden cardiac death (1131 vs. 1252; OR = 0.90; 95% CI 0.82–0.97, 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 0.71–0.87, P < 0.001). Results were not materially altered by inclusion of eight trials (involving 41 452 participants) of intensive vs. standard dose statin regimens.Conclusion: Statins 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.

U2 - 10.1093/eurheartj/ehs005

DO - 10.1093/eurheartj/ehs005

M3 - Article

VL - 33

SP - 1571

EP - 1581

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 13

ER -