Document Detail


Are lipid-lowering drugs also antiarrhythmic drugs? An analysis of the Antiarrhythmics versus Implantable Defibrillators (AVID) trial.
MedLine Citation:
PMID:  12849664     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study sought to evaluate the antiarrhythmic effects of lipid-lowering drug therapy as assessed by ventricular tachyarrhythmia (ventricular tachycardia [VT]/ventricular fibrillation [VF]) recurrences recorded by an implantable cardioverter defibrillator (ICD) in patients with atherosclerotic heart disease (ASHD). BACKGROUND: Randomized trials of lipid-lowering drugs suggest reduction of sudden death (SD) in patients with ASHD. Because SD is usually secondary to VT/VF, this observation suggests that lipid-lowering therapy has antiarrhythmic effects. METHODS: The probability of VT/VF recurrence in patients with ASHD treated with an ICD in the Antiarrhythmics Versus Implantable Defibrillators (AVID) trial who did not receive lipid-lowering drug therapy (n = 279) was compared with that in patients who received early and consistent lipid-lowering therapy (n = 83). In addition, all-cause mortality and cardiac mortality of all patients in the AVID trial with ASHD who did not receive lipid-lowering therapy (n = 564) were compared with that of those who received early and consistent lipid-lowering therapy (n = 149). RESULTS: Using multivariate analyses, lipid-lowering therapy was associated with a reduction in the relative hazard for VT/VF recurrence of 0.40 (95% confidence interval [CI] 0.15 to 0.58) (adjusted p = 0.003) in the ICD subgroup. Lipid-lowering therapy was also associated with a reduction in the relative hazard for all-cause mortality of 0.36 (95% CI 0.15 to 0.68) (adjusted p = 0.03) and a reduction in the relative hazard for cardiac mortality of 0.39 (95% CI 0.16 to 0.78) (adjusted p = 0.04) in the larger study population. CONCLUSIONS: In patients with ASHD who have received an ICD, lipid-lowering therapy is associated with reduction in the probability of VT/VF recurrence, suggesting that part of the benefit of lipid-lowering therapy may be due to an antiarrhythmic effect.
Authors:
L Brent Mitchell; Judy L Powell; Anne M Gillis; Victoria Kehl; Alfred P Hallstrom;
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  42     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-09     Completed Date:  2003-08-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Foothills Hospital/University of Calgary, 1403 29th Street NW, Calgary, Alberta, Canada T2N 2T9. brent.mitchell@calgaryhealthregion.ca
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MeSH Terms
Descriptor/Qualifier:
Aged
Antilipemic Agents / pharmacology*,  therapeutic use
Coronary Artery Disease / drug therapy*
Defibrillators, Implantable*
Female
Humans
Male
Middle Aged
Multicenter Studies as Topic
Recurrence / prevention & control
Survival Analysis
Tachycardia, Ventricular / drug therapy,  mortality,  prevention & control,  therapy*
Ventricular Fibrillation / drug therapy,  mortality,  prevention & control,  therapy*
Grant Support
ID/Acronym/Agency:
N02 HC 25117/HC/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Antilipemic Agents
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2003 Jul 2;42(1):88-92   [PMID:  12849665 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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