Statin therapy is associated with improved survival in patients with ventricular tachyarrhythmias

Jonas Rusnak, Michael Behnes, Tobias Schupp, Siegfried Lang, Linda Reiser, Gabriel Taton, Armin Bollow, Thomas Reichelt, Dominik Ellguth, Niko Engelke, Uzair Ansari, Ibrahim El-Battrawy, Thomas Bertsch, Christoph A Nienaber, Muharrem Akin, Kambis Mashayekhi, Christel Weiß, Martin Borggrefe, Ibrahim Akin, Jonas Rusnak, Michael Behnes, Tobias Schupp, Siegfried Lang, Linda Reiser, Gabriel Taton, Armin Bollow, Thomas Reichelt, Dominik Ellguth, Niko Engelke, Uzair Ansari, Ibrahim El-Battrawy, Thomas Bertsch, Christoph A Nienaber, Muharrem Akin, Kambis Mashayekhi, Christel Weiß, Martin Borggrefe, Ibrahim Akin

Abstract

Objectives: The study sought to assess the impact of statin therapy on survival in patients presenting with ventricular tachyarrhythmias.

Background: Data regarding the outcome of patients with statin therapy presenting with ventricular tachyarrhythmias is limited.

Methods: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT) or fibrillation (VF) from 2002 to 2016. Patients with statin were compared to patients without statin therapy (non-statin). The primary prognostic endpoint was long-term all-cause death at 3 years. Uni- and multivariable Cox regression analyses were applied in propensity-score matched cohorts.

Results: A total of 424 matched patients was included. The rates of VT and VF were similar in both groups (VT: statin 71% vs. non-statin 68%; VF: statin 29% vs. 32%; p = 0.460). Statin therapy was associated with lower all-cause mortality at long-term follow-up (mortality rates 16% versus 33%; log rank, p = 0.001; HR = 0.438; 95% CI 0.290-0.663; p = 0.001), irrespective of the underlying type of ventricular tachyarrhythmia (VT/VF), left ventricular ejection fraction (LVEF) > 35%, presence of an activated implantable cardioverter defibrillator (ICD), cardiogenic shock or cardiopulmonary resuscitation (CPR).

Conclusion: Statin therapy is independently associated with lower long-term mortality in patients presenting with ventricular tachyarrhythmias on admission.

Trial registration: Clinicaltrials.gov, NCT02982473 , 11/29/2016, Retrospectively registered.

Keywords: Statin therapy; Sudden cardiac death; Ventricular fibrillation; Ventricular tachyarrhythmias.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Overall all-cause mortality comparing statin with non statin patients (first panel), according to the underlying ventricular tachyarrhythmias, VT (second panel) and VF (third panel)
Fig. 2
Fig. 2
All-cause mortality comparing statin with non-statin patients according to LVEF ≥35% (left) and LVEF

Fig. 3

All-cause mortality comparing statin with…

Fig. 3

All-cause mortality comparing statin with non-statin patients according to the presence (left) or…

Fig. 3
All-cause mortality comparing statin with non-statin patients according to the presence (left) or absence of activated ICD (right)

Fig. 4

Statin therapy was still associated…

Fig. 4

Statin therapy was still associated with beneficial survival even after adjusting for several…

Fig. 4
Statin therapy was still associated with beneficial survival even after adjusting for several prognosis-relevant factors
Fig. 3
Fig. 3
All-cause mortality comparing statin with non-statin patients according to the presence (left) or absence of activated ICD (right)
Fig. 4
Fig. 4
Statin therapy was still associated with beneficial survival even after adjusting for several prognosis-relevant factors

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