Study |
Year |
Study design |
Population size (n) |
Patient population included |
SCD-related outcomes |
Results (comparing statin users and non-users) |
Ischemic heart disease |
Overall and combined CAD mortality |
4S[69] |
1994 |
RCT |
4444 |
History of angina pectoris or acute MI with high cholesterol levels |
Combined major coronary events including coronary deaths, resuscitated cardiac arrest, non-fatal acute MI, and silent MI |
Major coronary events reduced with simvastatin (p < 0.001) |
AFCAPS/TexCAPS[70] |
1998 |
RCT |
6605 |
Average TC and LDL-C levels and below-average HDL-C level, no known CAD |
First acute major coronary event defined as MI, unstable angina, or SCD. No separate analysis for SCD |
Lovastatin reduced the risk for the first acute major coronary event (p < 0.001) |
LIPID[71] |
1998 |
RCT |
9014 |
Known CAD |
Combined death from CAD (fatal MI, SCD, in-hospital death after possible MI or heart failure or another coronary cause) |
Reduced CAD (p < 0.001) and overall mortality (p < 0.001) with statins |
LaRosa et al.[72] |
1999 |
Meta-analysis of 5 RCTs |
30817 |
Studies where participants were randomized to statins versus controls and the primary outcome was clinical disease or death |
Combined major coronary events (unstable angina, silent MI, non-fatal MI, coronary death, resuscitated cardiac arrest or SCD) |
Risk reduction in major coronary events with statins (p < 0.01) |
SCD in patients without an ICD |
OPTIMAAL[73] |
2004 |
Retrospective |
5301 |
Acute MI with heart failure within 10 days of hospitalization |
SCD/resuscitated cardiac arrest |
Statins alone did not reduce SCD/resuscitated cardiac arrest |
Mäkikallio et al.[74] |
2006 |
Prospective |
2130 |
Acute MI |
SCD |
Absence of statins was a nonsignificant predictor of SCD |
Levantesi et al.[34] |
2007 |
Meta-analysis of 10 RCTs |
22 275 |
Studies with outcome focusing on the incidence of SCD, statin treatment compared with control |
SCD |
Statin treatment significantly reduced SCD (p = 0.03) |
CORONA[75] |
2007 |
RCT |
5011 |
Patients ≥60 years of age with ischemic systolic heart failure (NYHA II to IV) |
Death from cardiovascular causes (SCD reported separately) |
No reduction in mortality or SCD with rosuvastatin |
Vrtovec et al.[76] |
2008 |
RCT |
110 |
Patients with EF <30% (59% of patients had ischemic etiology) |
SCD |
Decreased incidence of SCD in the statin group (p = 0.012) |
GISSI-HF[77] |
2008 |
RCT |
4574 |
Patients ≥18 years of age with chronic heart failure (NYHA II to IV) irrespective of cause |
Time to death due to any cause or death or hospitalization due to cardiovascular cause (SCD reported separately) |
No reduction in mortality or SCD death with rosuvastatin |
SCD and related outcomes in patients with an ICD |
De Sutter et al.[78] |
2000 |
Prospective |
78 |
History of CAD and life-threatening VT/VF treated with an ICD |
Recurrences of VT/VF requiring ICD intervention |
Lipid-lowering drugs independently reduced recurrence of VT/VF (p = 0.004) |
AVID[79] |
2003 |
RCT sub-analysis |
362 |
Patients with CAD who received an ICD for secondary prevention of VT/VF |
VT/VF recurrence |
Reduction in VT/VF recurrence with statins (p = 0.003) |
Chiu et al.[80] |
2005 |
Prospective |
281 |
CAD and ICD implantation |
First appropriate ICD therapy |
Statins lowered ICD therapy for ventricular arrhythmias (p = 0.01) |
Riahi et al.[81] |
2005 |
Prospective |
86 |
CAD diagnosed by coronary angiography, with an ICD implantation (per ACC/AHA/NASPE 2002 ICD guidelines) |
VT/VF events |
No significant difference in the incidence of ventricular arrhythmias |
MADIT-II[13] |
2006 |
RCT sub-analysis |
654 |
History of MI one month or more before entry, EF <0.30, and ICD placement |
Occurrence of cardiac death or first appropriate ICD therapy for VT/VF |
Statins lowered VT/VF or cardiac death (p < 0.01) and SCD (p < 0.01) |
CLARIDI[82] |
2006 |
RCT |
106 |
CAD patients with ICD implants and TC levels lower than 250mg/dL |
Occurrence of ICD therapy for VT/VF |
Statins reduced ICD therapy for VT/VF (p = 0.04) |
Non-ischemic cardiomyopathy |
Overall and SCD in patients with an ICD |
DEFINITE[83] |
2006 |
RCT sub-analysis |
458 |
Non-ischemic cardiomyopathy with an EF <35%, symptomatic heart failure |
SCD from VT/VF |
One arrhythmic SCD in the 110 statin patients vs 18 of 348 in the non-statin group (p = 0.04) |
SCD-HeFT[84] |
2007 |
RCT sub-analysis |
2521 |
Both ischemic and non-ischemic cardiomyopathy |
All-cause mortality, no SCD outcome reported |
Reduction in mortality in both subgroups (ischemic and non-ischemic cardiomyopathy) |
Coleman et al.[85] |
2008 |
Prospective |
1204 |
Both ischemic and non-ischemic cardiomyopathy |
All-cause mortality and VT/VF incidence |
Reduction in overall mortality (p < 0.01) but not in VT/VF (p = 0.14) |
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