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- Title
Statins and the Reduction of Sudden Cardiac Death: Antiarrhythmic or Anti-Ischemic Effect?
- Authors
Beri, Abhimanyu; Contractor, Tahmeed; Khasnis, Atul; Thakur, Ranjan
- Abstract
Sudden cardiac death is an important cause of cardiovascular mortality with the majority of cases occurring in low-risk groups. HMG-CoA reductase inhibitors (statins) have recently been shown to reduce the incidence of ventricular tachycardia (VT)/fibrillation (VF) and sudden cardiac death, and this has been attributed to their pleiotropic effects. However, it is unclear whether this occurs through an 'indirect' anti-ischemic or 'direct' antiarrhythmic effect. We systematically reviewed articles published on MEDLINE between January 1996 and December 2009 focusing on the reduction of VT/VF and sudden cardiac death by statins and the potential mechanisms. Studies reporting sudden cardiac death or VT/VF outcomes with statin use (n = 23) or the pathophysiology of sudden cardiac death reduction by statins (n = 19)were included. We found that statins have been shown to reduce VT/VF and sudden cardiac death only in subjects with underlying coronary artery disease or ischemic cardiomyopathy. No definite benefits were seen with statins in sudden cardiac death and VT/VF in patients with non-ischemic cardiomyopathy. There is insufficient evidence to point toward a benefit in populations at low risk for VT/VF. In conclusion, an anti-ischemic rather than a primary antiarrhythmic effect emerges as the likely mechanism of sudden cardiac death reduction with statins.
- Subjects
CARDIAC arrest prevention; ISCHEMIA prevention; INFLAMMATION prevention; ARRHYTHMIA; AUTONOMIC nervous system; CARDIAC arrest; CORONARY disease; MEDLINE; CARDIOMYOPATHIES; HEALTH outcome assessment; VENTRICULAR fibrillation; VENTRICULAR tachycardia; SYSTEMATIC reviews; STATINS (Cardiovascular agents); TREATMENT effectiveness; PHARMACODYNAMICS
- Publication
American Journal of Cardiovascular Drugs, 2010, Vol 10, Issue 3, p155
- ISSN
1175-3277
- Publication type
Article
- DOI
10.2165/11536690-000000000-00000