To investigate the effect of statins on appropriate cardioverter-defibrillator (CD) shocks and mortality in patients with heart failure treated with combined cardiac resynchronization therapy (CRT) and CDs.
Of 209 patients, mean age 72 years, with heart failure treated with combined CRT and CDs, 121 (58%) were treated with statins. Mean follow-up was 35 months for patients on statins and 32 months for patients not on statins (p not significant).
Appropriate CD shocks occurred in 22 of 121 patients (18%) on statins versus 30 of 88 patients (34%) not on statins (p = 0.009). Deaths occurred in 3 of 121 patients (2%) on statins versus 9 of 88 patients (10%) not on statins (p = 0.017). Stepwise Cox regression analysis using the variables gender, age, use of statins, beta blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, amiodarone, sotalol, and digoxin, ischemic heart disease, nonischemic heart disease, smoking, dyslipidemia, hypertension, diabetes, and left ventricular ejection fraction showed that significant independent prognostic factors for appropriate CD shocks were use of statins (risk ratio = 0.46, p = 0.008), smoking (risk ratio = 3.5, p = 0.0006), and diabetes (risk ratio = 0.34, p = 0.031). Significant independent prognostic factors for the time to all-cause mortality were use of statins (risk ratio = 0.05, p = 0.0004), use of digoxin (risk ratio = 4.2, p = 0.027), hypertension (risk ratio = 14.2, p = 0.016), diabetes (risk ratio = 4.3, p = 0.031), and left ventricular ejection fraction (risk ratio = 1.1, p value = 0.006).
Use of statins significantly reduced appropriate CD shocks and all-cause mortality in patients with heart failure treated with combined CRT and CDs.
Patients with heart failure treated with combined CRT and CDs should be treated with statins to reduce all-cause mortality and appropriate CD shocks.
Harit Desai, No Financial Disclosure Information; No Product/Research Disclosure Information