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Wake Up and Smell the Coffee: Yet Another No Go for Cardiac Patients?: Editorial to “Caffeinated Coffee Blunts the Myocardial Protective Effects of Statins Against Ischemia–reperfusion Injury in the Rat” by Ye et al.
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Meta-analysis of effect of statin treatment on risk of sudden death
Despite significant progress in the prevention and treatment of cardiovascular
disease, sudden cardiac death (SCD) is a major public health problem. Statins
showed consistent benefits on cardiovascular events, but scant data were
available about their effects on SCD. This meta-analysis aimed to assess the
effect of statins on SCD. Additional analyses were carried out to evaluate lipid
reduction as a possible mediator of the effect. Randomized controlled trials from
January 1966 to July 2006 were retrieved by searching the MEDLINE database.
Inclusion criteria were outcome focusing on the incidence of SCD, statin
treatment compared with placebo or no treatment, randomized design, >or=100
patients enrolled, and follow-up>or=6 months. Data were independently abstracted
by 2 investigators using a standardized protocol. Ten randomized controlled
trials 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 subgroup
analysis, the benefit of statins was independent from the main characteristics of
the studies and changes in patient lipid levels during the study. In conclusion,
our results suggest that statins decrease the risk of SCD