Reduction in life-threatening ventricular tachyarrhythmias in statin-treated patients with nonischemic cardiomyopathy enrolled in the madit-crt (multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy)
JACC Cardiovascular Interventions, 08/20/2012
Buber J et al. – Statin use was associated with a significant reduction in the risk of life–threatening ventricular tachyarrhythmias among patients with nonischemic cardiomyopathy (NICM).Methods
- Multivariate Cox proportional hazards regression modeling was used to assess the effect of statin therapy, evaluated as a time–dependent covariate, on the risk of appropriate defibrillator therapy for fast ventricular tachycardia (VT) (defined as a rate faster than 180 beats/min)/ventricular fibrillation (VF) or death (primary endpoint) and appropriate defibrillator shocks (secondary endpoint) among 821 patients with NICM enrolled in the MADIT–CRT trial.
- Statin users (n = 499) were older and had a higher prevalence of diabetes and hypertension yet were less frequently smokers.
- Multivariate analysis showed that time–dependent statin therapy was independently associated with a significant 77% reduction in the risk of fast VT/VF or death (p < 0.001) and with a significant 46% reduction in the risk of appropriate implantable cardioverter defibrillator shocks (p = 0.01).
- Consistent with these findings, the cumulative probability of fast VT/VF or death at 4 years of follow–up was significantly lower among patients who were treated with statins (11%) as compared with study patients who were not treated with statins (19%; p = 0.006 for the overall difference during follow–up).