| OBJECTIVES:Current evidence suggests that hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors have emerged as novel drugs in preventing sudden cardiac death (SCD). This meta-analysis was designed to assess the effects of HMG-CoA reductase inhibitors in the prevention of SCD.METHODS:A systemic literature search in MEDLINE, EMBASE, and Cochrane Controlled Trials Register (CCRT) was performed and randomized controlled trials (RCTs) involving the prevention of SCD by HMG-CoA reductase inhibitors were collected. Effect size was expressed as odds ratio (OR) with 95% confidence interval (CI). Subgroup analyses were performed to explore the influence of potential variables to the effects of those drugs.RESULTS:A total of 40709 patients from 17 trials entered into this study. Overall, HMG-CoA reductase inhibitors treatment was associated with a significant risk reduction for SCD (OR,0.85; 95% CI0.72-0.99), especially in those with left ventricular ejection fraction (LVEF)≤30%(OR,0.23; 95% CI 0.08-0.64). Obvious benefits were also observed in patients less than 65 years old (OR,0.74; 95% CI 0.63-0.87), as well as those with low density lipoprotein-cholesterol (LDL-C)>160mg/dl (OR,0.56; 95% CI 0.40-0.80).CONCLUSIONS: This study suggests that HMG-CoA reductase inhibitors show significant effect on the prevention of SCD, especially in patients with lower age, lower LVEF and higher LDL-C level. |
