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

Abhimanyu Beri; Tahmeed Contractor; Atul Khasnis; Ranjan Thakur


Am J Cardiovasc Drugs. 2010;10(3):155-164. 

In This Article

5. Conclusion

Sudden cardiac death remains an important public health concern and occurs predominantly in low-risk populations. The effects of statins on sudden cardiac death reduction have only been analyzed in high-risk groups, mostly through observational studies or post hoc analysis of RCTs. Although statins have been shown to reduce sudden cardiac death and VT/VF in subjects with underlying coronary artery disease, similar benefits have not been consistently demonstrated in patients with non-ischemic cardiomyopathy.

The benefits of statins in reducing VT/VF and sudden cardiac death in low-risk populations remain unclear. Many studies do not report the use of specific statins thereby precluding the conclusion of whether or not this is a 'class-effect'. The exact mechanism underlying the reduction in VT/VF and sudden cardiac death by statins is also under debate. Based on existing studies, an anti-ischemic effect seems to be more likely than a direct antiarrhythmic effect. Because ICDs help ascertain arrhythmic events definitively, further trials involving high-risk subjects with ICDs placed for non-ischemic etiologies will be best able to evaluate primary antiarrhythmic effects of statins.