Author/Editor     Vrtovec, B; Okrajšek, R; Goličnik, A; Ferjan, M; Starc, V; Schlegel, TT; Radovancevic, B
Title     Atorvastatin therapy may reduce the incidence of sudden cardiac death in patients with advanced chronic heart failure
Type     članek
Source     J Card Fail
Vol. and No.     Letnik 14, št. 2
Publication year     2008
Volume     str. 140-4
Language     eng
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. Methods and 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). Conclusion: 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.
Descriptors     HEART FAILURE, CONGESTIVE
DEATH, SUDDEN, CARDIAC
ANTILIPEMIC AGENTS
HYPERCHOLESTEROLEMIA
NATRIURETIC HORMONE
CARDIAC OUTPUT, LOW
RETROSPECTIVE STUDIES