The effect of statin therapy on ventricular tachyarrhythmias: a meta-analysis.

The objective of this study was to assess whether statin therapy is associated with a reduction in ventricular tachyarrhythmias. Statins have been shown to be beneficial beyond their cholesterol-lowering effects. These pleiotropic effects have been implicated in the protection against atrial fibrillation and the reduction in appropriate implantable cardioverter-defibrillator therapy in patients with coronary artery disease. This meta-analysis was conducted to evaluate whether statins were associated with a reduction in ventricular tachyarrhythmias in patients with coronary artery disease or nonischemic cardiomyopathy. The Medline and Cochrane databases were searched for studies in human subjects published in the English language between 1985 and February 2010. Studies were included in our analysis if they provided data regarding the association between the use of statins and the incidence of ventricular tachycardia/ventricular fibrillation (VT/VF) in patients with coronary artery disease or nonischemic cardiomyopathy. The occurrence of ventricular arrhythmias was defined as the VT/VF occurrence or appropriate implantable cardioverter-defibrillator therapy for VT/VF. Of the 166 identified articles, nine prospective studies with 150,953 patients enrolled met our inclusion criteria and were included in this analysis. Using a random effects model, statin therapy was associated with a 31% reduction in the risk of VT/VF when compared with the group not on statin therapy (pooled relative risk = 0.69, 95% confidence interval, 0.58-0.83; heterogeneity I² = 57.3%). There was a low likelihood of publication bias in this analysis (Egger's test P = 0.957). Statin use in patients with coronary artery disease or nonischemic cardiomyopathy is associated with a 31% reduction in the development of ventricular tachyarrhythmias.

No evidence of increased prevalence of premature coronary artery disease in New York City police officers as predicted by coronary artery calcium scoring.

OBJECTIVES: To investigate the prevalence of coronary artery disease (CAD) in active New York City police officers as detected by coronary artery calcium (CAC) scoring. METHODS: We assessed 2064 New York City police officers who underwent electron beam computed tomography for quantification of CAC. RESULTS: The mean age of study subjects was 42 +/- 6 years. A CAC score of 0 was present in 74% of men and 80% of women. A subset of 75 officers with known early exposure to World Trade Center dust were evaluated separately. CONCLUSION: New York City police officers do not have an increased prevalence of CAD compared with the general population as assessed with CAC scoring. At 5 years, exposure to World Trade Center dust does not appear to increase the risk of premature CAD.

Atrial fibrillation and obesity--results of a meta-analysis.

BACKGROUND: Obesity has been shown to be associated with atrial enlargement and ventricular diastolic dysfunction, both of which are risk factors for atrial fibrillation (AF). However, the role of obesity as a risk factor for the development of AF is unknown. The study aims to evaluate the role of obesity as a risk factor for the development of AF. METHODS: The MEDLINE/ PUBMED and Cochrane databases were searched for studies in human subjects published in English language between 1966 and May 2007. Studies were included in our analyses if they were population-based cohort or postcardiac surgery cohort and investigated the incidence of AF in relation to the body mass index (BMI) categories. RESULTS: Of the 468 articles identified, 16 studies that enrolled a total of 123,249 individuals met the inclusion criteria. These 16 articles included 5 population-based cohort studies that enrolled 78,602 adult individuals from the United States and 3 European countries and 11 postcardiac surgery studies that enrolled 44,647 patients. Based on the population-based cohort studies, obese individuals have an associated 49% increased risk of developing AF compared to nonobese individuals (relative risk 1.49, 95% CI 1.36-1.64). The risk of AF increased in parallel with greater BMI in this cohort. In contrast, in the postcardiac surgery studies, obese individuals do not have an associated increased risk of developing AF compared to nonobese individuals (relative risk 1.02, 95% CI 0.99-1.06). CONCLUSIONS: Our findings demonstrate that obesity increased the risk of developing AF by 49% in the general population, and the risk escalated in parallel with increased BMI. Thus, AF evolves as yet another pathogenetic factor by which obesity may increase cardiovascular and cerebrovascular events.