Prevention of sudden death in patients with coronary artery disease: do lipid-lowering drugs play a role?

Ventricular arrhythmias are the most common cause of sudden cardiac death in patients with coronary artery disease. Since treatment of hypercholesterolemia in patients with coronary artery disease reduces the risk of major coronary events by about 30%, one could speculate that this treatment could also result in a reduction of arrhythmic episodes in high-risk patients. In this review, the importance of myocardial ischemia as a trigger for ventricular arrhythmias, as well as the available data that suggest a possible effect of anti-ischemic treatments, including lipid-lowering drugs, on these arrhythmias are presented. Also, possible mechanisms and future research to test the hypothesis that lipid-lowering drugs can reduce life-threatening ventricular arrhythmias are discussed.