Statins reduce appropriate cardioverter-defibrillator shocks and mortality in patients with heart failure and combined cardiac resynchronization and implantable cardioverter-defibrillator therapy.
Of 209 patients with heart failure treated with combined cardiac resynchronization therapy and implantable cardioverter-defibrillator therapy, appropriate cardioverter-defibrillator shocks occurred at 34-month follow-up in 22 of 121 patients (18%) on statins and in 30 of 88 patients (34%) not on statins (P = .009). Deaths occurred in 3 of 121 patients (2%) on statins and in 9 of 88 patients (10%) not on statins (P = .017). Stepwise Cox regression analysis showed that significant independent prognostic factors for appropriate shocks were use of statins (risk ratio = 0.46), smoking (risk ratio = 3.5), and diabetes (risk ratio = 0.34). Significant independent prognostic factors for the time to mortality were use of statins (risk ratio = 0.05), use of digoxin (risk ratio = 4.2), systemic hypertension (risk ratio = 14.2), diabetes (risk ratio = 4.3), and left ventricular ejection fraction (risk ratio = 1.1).
Desai
Harit
H
Department of Medicine, New York Medical College, Valhalla, 10595, USA.
Aronow
Wilbert S
WS
Tsai
Fausan S
FS
Ahn
Chul
C
Lai
Hoang M
HM
Amin
Harshad
H
Gandhi
Kaushang
K
Frishman
William H
WH
Cohen
Martin
M
Sorbera
Carmine
C
D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial; D002316:Cardiotonic Agents / Q000009:adverse effects; D003131:Combined Modality Therapy; D017147:Defibrillators, Implantable; D048909:Diabetes Complications / Q000401:mortality / Q000628:therapy; D004077:Digoxin / Q000009:adverse effects; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006973:Hypertension / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013318:Stroke Volume; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016277:Ventricular Function, Left
D002316:Cardiotonic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D004077:Digoxin