Effect of previous statin use on the incidence of sustained ventricular tachycardia and ventricular fibrillation in patients presenting with acute coronary syndrome

Objective: Recent studies suggest that statins have anti-arrhythmic effects. The aim of this study was to evaluate the effects of statins on sustained ventricular tachycardia or ventricular fibrillation (S-VT or VF) in patients presenting with acute coronary syndrome (ACS). Methods: The population of this study consisted of consecutive patients admitted to coronary care unit. It was an observational case-controlled retrospective analysis performed on prospective cohort. From a total of 1000 patients presenting with ACS, 241 were on and 759 were not on statin. Patient demographics, clinical characteristics and previous medical treatment including statins were recorded. A S-VT or VF episode during hospitalization was accepted as endpoint. Multiple logistic regression model was performed which considered the occurrence of S-VT or VF as the response variable. Results: Sustained VT or VF occurred in 3.3% of patients in statin group and in 9% of patients in non-statin group. Univariate positive predictors of S-VT or VF were ST elevation myocardial infarction as clinical presentation, smoking and thrombolysis; univariate negative predictors of S-VT or VF were ejection fraction, use of acetylsalicylic acid before hospitalization, use of statin before hospitalization, initiation of clopidogrel at the hospital and normal coronary arteries. In the multiple logistic regression analysis, the only independent predictor of S-VT or VF was ejection fraction (OR 0.96; 95% CI 0.93 to 0.99; p=0.005). Conclusion: Our results indicate that, although the incidence of S-VT/VF was significantly lower in patients with ACS and previous statin use; statin use is not an independent predictor of the occurrence of S-VT or VF in patients presenting with ACS.