Statins Related Reduction In Major Ventricular Tachyarrhythmias (TV/FV) In Patients With Ischemic Cardiopathy Undergoing ICD Implantation For Primary Prevention

Massimiliano Manfrin*, Werner Rauhe and Roberto Cemin

Received: March 15, 2018;   Published: April 04, 2018

DOI: 10.26717/BJSTR.2018.03.000911

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Abstract

Purpose: to evaluate the anti-arrhythmic effect of statins in patients receiving an implantable cardioverter-defibrillator (ICD) for ventricular tachycardia/ventricular fibrillation (VT/VF).

Methods: 85 patients with ischemic dilated cardiomyopathy undergoing ICD implantation for sudden cardiac death (SCD) prevention (primary prevention) were enrolled in the study. 63 patients (72%) were on treatment with statins (group 1), and 22 were not (group 2). The following end points were analyzed: recurrences of ventricular arrhythmias (VA) requiring ICD intervention and mortality.

Results: after a median follow up of 46.2 months (interquartile range 26.9 - 72.8 months) 28 patients (32.9%) had at least one VA which required ICD intervention. Multivariate analysis showed that treatment with statins was the only independent predictor of arrhythmic events reduction (events requiring ICD intervention) (p=0.042). Under the 63 patients of group 1, 17 (27%) had appropriate ICD intervention, while under the 22 patients of group 2, 11 (50%) had appropriate ICD intervention (p=0.0185). The mortality in group 1 was 28.6% (18 patients), while in group 2 was 50% (11 patients) (p=0.0284).

Conclusion: the use of statins in patients with ischemic dilated cardiomyopathy undergoing ICD implantation was associated with a reduction in the risk of death and VT/VF episodes requiring ICD intervention. These findings suggest that statins may have anti-arrhythmic properties. These findings should be confirmed in a prospective, randomized clinical trial.

Abbreviations: ICD: Implantable Cardioverter-Defibrillator; SCD: Sudden Cardiac Death; CAD: Coronary Artery Disease; SCD: Sudden Cardiac Deaths; HR: Heart Rate; FVT: Fast Ventricular Tachycardia; VF: Ventricular Fibrillation

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