Statin use and ventricular arrhythmias during clinical treadmill testing

Area of Science:

• Cardiology
• Clinical Exercise Physiology
• Pharmacology

Background:

• Premature ventricular complexes (PVCs) during exercise indicate poor prognosis, especially with intermediate treadmill test results.
• Statins are known to reduce resting ventricular arrhythmias in coronary artery disease patients.
• The impact of statins on exercise-induced ventricular arrhythmias remains uninvestigated.

Purpose of the Study:

• To investigate the association between statin use and the occurrence of PVCs during and after clinical exercise treadmill testing.
• To determine if statin therapy influences the frequency of exercise-induced ventricular arrhythmias.

Main Methods:

• A cohort of 1,847 heart-failure-free patients undergoing exercise treadmill testing was analyzed.
• PVCs were quantified, with frequent PVCs defined by median rates during exercise and recovery.
• Propensity-adjusted logistic regression models assessed the odds of frequent PVCs in statin users versus non-users.

Main Results:

• Statin users (n=145) showed significantly lower odds of frequent PVCs during exercise (OR 0.58) and recovery (OR 0.56) after propensity score adjustment.
• Specifically, statin use was associated with a 42% reduction in frequent exercise PVCs and a 44% reduction in frequent recovery PVCs.
• These associations were consistent across subgroups, regardless of age, prior coronary disease, hypercholesterolemia, exercise-induced angina, or exercise capacity.

Conclusions:

• Statin use is associated with a reduced likelihood of frequent premature ventricular complexes during and after exercise testing.
• This protective effect appears independent of statins' known benefits for coronary disease or ischemia.
• Findings suggest a potential role for statins in managing exercise-related ventricular arrhythmias.