Meta-analysis of effect of statin treatment on risk of sudden death

Despite significant progress in the prevention and treatment of cardiovasculardisease, sudden cardiac death (SCD) is a major public health problem. Statinsshowed consistent benefits on cardiovascular events, but scant data wereavailable about their effects on SCD. This meta-analysis aimed to assess theeffect of statins on SCD. Additional analyses were carried out to evaluate lipid reduction as a possible mediator of the effect. Randomized controlled trials fromJanuary 1966 to July 2006 were retrieved by searching the MEDLINE database.Inclusion criteria were outcome focusing on the incidence of SCD, statintreatment compared with placebo or no treatment, randomized design, >or=100patients enrolled, and follow-up>or=6 months. Data were independently abstracted by 2 investigators using a standardized protocol. Ten randomized controlledtrials enrolling a total of 22,275 patients were included in the meta-analysis.Risks of SCD were 3% in patients receiving statins and 3.8% in control patients. Statin treatment was associated with a significant 19% risk reduction for SCD(odds ratio 0.81, 95% confidence interval 0.71 to 0.93, p=0.003). In subgroupanalysis, the benefit of statins was independent from the main characteristics ofthe studies and changes in patient lipid levels during the study. In conclusion, our results suggest that statins decrease the risk of SCD.