Abstract 3773: Impact of Chronic Statin Therapy on Arrhythmic Events in Patients With Acute Coronary Syndromes. The GRACE registry
Background: Animal studies have demonstrated a reduction in arrhythmias with the use of statins in models of myocardial ischemia. We hypothesized that chronic statin therapy might be associated with a reduction of in-hospital arrhythmic events in patients with acute coronary syndromes (ACS).
Methods: We evaluated the in-hospital outcomes in 48,930 patients enrolled in the GRACE registry between 1999 and 2006 with an admission diagnosis of ACS. Patients were divided into two groups based on prior statin use. The primary outcome measure for this analysis was in-hospital occurrence of ventricular tachycardia (VT), ventricular fibrillation (VF) and atrial fibrillation (AF).
Results: A total of 13,539 (28%) patients were on prior chronic statins and 35,391 (72%) were not. Those on chronic statins had higher rates of history of angina (69% vs 44%), diabetes (34% vs 22%), heart failure (15% vs 8%), hypertension (74% vs 58%), atrial fibrillation (9% vs 7%) and hyperlipidemia (84% vs 35%). They also had lower rates of in-hospital arrhythmias (Figure⇓). Chronic statin use remained strongly associated with a reduction in VT/VF (adjusted OR 0.61, 95% CI 0.54 – 0.69; P<0.0001) and AF (adjusted OR 0.71, 95% CI 0.62– 0.80; P<0.0001) in propensity-adjusted multivariable models.
Conclusion: Patients on prior statins had a lower incidence of in-hospital arrhythmic events following ACS. It is not clear if the relationship is causal. Data from future randomized trials would need to definitively establish this association. Our study suggests another possible benefit from appropriate primary and secondary prevention therapy with statins.