title: Atorvastatin therapy may reduce the incidence of sudden cardiac death in patients with advanced chronic heart failure.
abstract: BACKGROUND
  In retrospective studies, statin therapy has been related to decreased incidence of sudden cardiac death (SCD) in heart failure. We sought to prospectively investigate a relation between atorvastatin therapy and SCD in patients with advanced chronic heart failure.
  
  
  RESULTS
  We enrolled 110 patients with heart failure with a left ventricular ejection fraction less than 30% and cholesterol level greater than 150 mg/dL. Fifty-five patients were randomized to atorvastatin (10 mg/day) (statin group); the remaining 55 patients received no statins (controls). Patients were followed for 1 year. At baseline, the two groups did not differ in age, sex, left ventricular ejection fraction, cholesterol, B-type natriuretic peptide, heart rate variability, or QT variability. During follow-up, 29 patients died (26%) and 2 patients (2%) underwent heart transplantation. Of the 29 deaths, 13 were attributed to pump failure, 15 were attributed to SCD, and 1 was attributed to noncardiac causes. All-cause mortality was lower in the statin group (9/55, 16%) than in controls (20/55, 36%) (P = .017). The same was true of the SCD rate (3/55 [5%] vs. 12/55 [22%], P = .012), but not of the pump failure (5/55 [9%] vs. 8/55 [15%], P = .38). SCD-free survival was 2.3-times higher in the statin group than in controls (P = .01).
  
  
  CONCLUSIONS
  Atorvastatin therapy seems to be associated with decreased incidence of SCD in patients with advanced chronic heart failure. Larger studies are ongoing to confirm this hypothesis.
authors.affiliation: Advanced Heart Failure Center, Department of Cardiology, Ljubljana University Medical Center, Ljubljana, Slovenia. bojan.vrtovec@gmail.com
authors.forename: Bojan
authors.initials: B
authors.lastname: Vrtovec
authors.forename: Renata
authors.initials: R
authors.lastname: Okrajsek
authors.forename: Alenka
authors.initials: A
authors.lastname: Golicnik
authors.forename: Mateja
authors.initials: M
authors.lastname: Ferjan
authors.forename: Vito
authors.initials: V
authors.lastname: Starc
authors.forename: Todd T
authors.initials: TT
authors.lastname: Schlegel
authors.forename: Branislav
authors.initials: B
authors.lastname: Radovancevic
mesh_terms: D000069059:Atorvastatin; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D018450:Disease Progression; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology*; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use*; D012307:Risk Factors; D013318:Stroke Volume
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D020097:Natriuretic Peptide, Brain; D000069059:Atorvastatin