Meta-Analysis of Effect of Statin Treatment on Risk of Sudden Death

Meta-Analysis of Effect of Statin Treatment on Risk of Sudden Death

Title: Meta-Analysis of Effect of Statin Treatment on Risk of Sudden Death

Topic: Arrhythmias

Date Posted: 1/11/2008

Author(s): Levatesi G, Scarano M, Marfisi R, et al.

Citation: Am J Cardiol. 2007;100:1644-1650.


Study Question: Do statins prevent sudden death (SD)?

Methods: This was a meta-analysis of 10 randomized, controlled trials in which a statin was compared with placebo or no therapy. There were a total of 22,275 patients, with 11,136 randomly assigned to receive a statin. The mean age was 60 years, 81% were male, and 69% had a history of myocardial infarction. The mean duration of follow-up was 4.4 years.

Results: The incidence of SD was significantly lower in the statin group (3.0%) than in the control group (3.8%). The 19% reduction in relative risk of SD in the statin group was independent of the extent to which the plasma cholesterol level decreased.

Conclusions: Stains reduce the relative risk of SD by approximately 20% over 4 years of follow-up.

Perspective: A reduction in SD by statins is consistent with the results of implantable cardioverter defibrillator trials that have demonstrated a reduction in the risk of appropriate shocks in patients treated with a statin. There are several possible mechanisms by which statins might reduce the risk of malignant ventricular arrhythmias, including prevention of ischemia and indirect channel effects mediated by alterations in the lipid content of cell membranes. Fred Morady, M.D., F.A.C.C.