Statins and the Reduction of Sudden Cardiac Death Antiarrhythmic or Anti-Ischemic Effect?

被引:23
作者
Beri, Abhimanyu [1 ]
Contractor, Tahmeed [1 ]
Khasnis, Atul [2 ]
Thakur, Ranjan [3 ]
机构
[1] Michigan State Univ, Div Internal Med, E Lansing, MI 48824 USA
[2] Cleveland Clin, Dept Rheumatol, Cleveland, OH 44106 USA
[3] Thorac & Cardiovasc Inst, Dept Clin Cardiac Electrophysiol, Lansing, MI USA
关键词
HEART-RATE-VARIABILITY; C-REACTIVE PROTEIN; CORONARY-ARTERY-DISEASE; IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS; VENTRICULAR LATE POTENTIALS; ACUTE MYOCARDIAL-INFARCTION; LIPID-LOWERING DRUGS; CARDIOVASCULAR-DISEASE; PRIMARY PREVENTION; UNSTABLE ANGINA;
D O I
10.2165/11536690-000000000-00000
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:155 / 164
页数:10
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