Statins Reduce Appropriate Cardioverter-Defibrillator Shocks and Mortality in Patients With Heart Failure and Combined Cardiac Resynchronization and Implantable Cardioverter-Defibrillator Therapy

• Published in: Journal of cardiovascular pharmacology and therapeutics Vol. 14; no. 3; pp. 176 - 179
• Main Authors: Desai, Harit, Aronow, Wilbert S., Tsai, Fausan S., Ahn, Chul, Lai, Hoang M., Amin, Harshad, Gandhi, Kaushang, Frishman, William H., Cohen, Martin, Sorbera, Carmine
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.09.2009
• Subjects: Aged; Aged, 80 and over; Cardiac Pacing, Artificial; Cardiotonic Agents - adverse effects; Combined Modality Therapy; Defibrillators, Implantable; Diabetes Complications - mortality; Diabetes Complications - therapy; Digoxin - adverse effects; Female; Heart Failure - complications; Heart Failure - drug therapy; Heart Failure - mortality; Heart Failure - therapy; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypertension - complications; Hypertension - mortality; Male; Middle Aged; Odds Ratio; Proportional Hazards Models; Risk Assessment; Risk Factors; Smoking - adverse effects; Stroke Volume; Tachycardia, Ventricular - etiology; Tachycardia, Ventricular - mortality; Tachycardia, Ventricular - prevention & control; Time Factors; Treatment Outcome; Ventricular Fibrillation - etiology; Ventricular Fibrillation - mortality; Ventricular Fibrillation - prevention & control; Ventricular Function, Left; heart failure; cardiac resynchronization therapy; cardioverter-defibrillator shocks; statins
• ISSN: 1074-2484; 1940-4034
• DOI: 10.1177/1074248409340157

Of 209 patients with heart failure treated with combined cardiac resynchronization therapy and implantable cardioverter-defibrillator therapy, appropriate cardioverter-defibrillator shocks occurred at 34-month follow-up in 22 of 121 patients (18%) on statins and in 30 of 88 patients (34%) not on statins (P = .009). Deaths occurred in 3 of 121 patients (2%) on statins and in 9 of 88 patients (10%) not on statins (P = .017). Stepwise Cox regression analysis showed that significant independent prognostic factors for appropriate shocks were use of statins (risk ratio = 0.46), smoking (risk ratio = 3.5), and diabetes (risk ratio = 0.34). Significant independent prognostic factors for the time to mortality were use of statins (risk ratio = 0.05), use of digoxin (risk ratio = 4.2), systemic hypertension (risk ratio = 14.2), diabetes (risk ratio = 4.3), and left ventricular ejection fraction (risk ratio = 1.1).