Do statins influence the prognostic impact of non-sustained ventricular tachycardia after ST-elevation myocardial infarction?
OBJECTIVE
The study evaluates the effect of statin therapy on the prognostic impact of non-sustained ventricular tachycardia (NSVT) occurring after acute ST-elevation myocardial infarction (STEMI).


RESULTS
From the German Acute Coronary Syndrome Registry (ACOS), 3137 patients with STEMI and in-hospital Holter monitoring were analysed. Three hundred and forty-six (11.0%) patients had NSVT. When compared with patients with no documented NSVT, patients with NSVT were older, more often had myocardial infarction in their history, diabetes mellitus, and an ejection fraction <40%. Regarding frequency of drug application, medication at discharge did not (beta-blockers, ACE-inhibitors, amiodarone) or only slightly (acetylsalicylic acid, statins, and sotalol) differ between both groups. Multivariable analysis of 1 year mortality, adjusted for age, gender, diabetes, reperfusion therapy, ejection fraction <40%, and beta-blocker therapy showed the following results: In patients without statin treatment and no NSVT, 1 year mortality after STEMI was 9.2%, but increased to 25.0% [odds ratio (OR) 3.02; 95% confidence interval (CI) 1.47-6.20], if NSVT were present. In patients on statin treatment and no NSVT, 1 year mortality was only 3.2%, and in the presence of NSVT 1 year mortality was not significantly increased anymore (5.3%; OR 1.03; 95% CI 0.55-1.92).


CONCLUSIONS
After STEMI, only in patients not on statin treatment, the occurrence of NSVT is associated with a significant and marked increase in 1 year mortality.
Lorenz
Herbert
H
Institut für Herzinfarktforschung, Klinikum der Stadt Ludwigshafen, Bremserstr. 79, D-67063 Ludwigshafen am Rhein, Herzzentrum Ludwigshafen, Germany.
Jünger
Claus
C
Seidl
Karlheinz
K
Gitt
Anselm
A
Schneider
Steffen
S
Schiele
Rudolf
R
Wienbergen
Harm
H
Winkler
Ralph
R
Gottwik
Martin
M
Delius
Wolfram
W
Senges
Jochen
J
Rauch
Bernhard
B
D000368:Aged; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality; D011446:Prospective Studies; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors