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Statin-associated muscle symptoms: impact on statin therapy-European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management.

  • Stroes ES Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands e.s.stroes@amc.uva.nl.
  • Thompson PD Hartford Hospital, Hartford, CT, USA.
  • Corsini A University of Milan and Multimedica IRCSS Milano, Italy.
  • Vladutiu GD School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
  • Raal FJ University of the Witwatersrand, Johannesburg, South Africa.
  • Ray KK St. Georges's University of London, UK.
  • Roden M Department of Endocrinology and Diabetology, University Hospital Düsseldorf Heinrich-Heine University, and Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Germany.
  • Stein E Metabolic and Atherosclerosis Research Centre, Cincinnati, OH, USA.
  • Tokgözoğlu L Hacettepe University, Ankara, Turkey.
  • Nordestgaard BG Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Denmark.
  • Bruckert E Pitié-Salpetriere University Hospital, Paris, France.
  • De Backer G Ghent University, Ghent, Belgium.
  • Krauss RM Children's Hospital Oakland Research Institute, Oakland, CA, USA.
  • Laufs U Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
  • Santos RD University of Sao Paulo, Brazil.
  • Hegele RA Western University, London, ON, Canada.
  • Hovingh GK Academic Medical Center, University of Amsterdam, The Netherlands.
  • Leiter LA Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Canada.
  • Mach F Cardiology Service, HUG, Geneva, Switzerland.
  • März W Synlab Center of Laboratory Diagnostics Heidelberg, Heidelberg, Germany.
  • Newman CB New York University School of Medicine, New York, USA.
  • Wiklund O Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Jacobson TA Emory University School of Medicine, Atlanta, GA, USA.
  • Catapano AL University of Milan and Multimedica IRCSS Milano, Italy.
  • Chapman MJ INSERM, Pitié-Salpetriere University Hospital, Paris, France.
  • Ginsberg HN
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  • 2015-02-20
Published in:
  • European heart journal. - 2015
Cholesterol
Consensus statement
Lipids
Mitochondrial
Muscle symptoms
Myalgia
Myopathy
Statin
Statin intolerance
Cholesterol Ester Transfer Proteins
Complementary Therapies
Consensus
Creatine Kinase
Diet
Genetic Predisposition to Disease
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hypolipidemic Agents
Mitochondria, Muscle
Mitochondrial Diseases
Muscular Diseases
Proprotein Convertase 9
Proprotein Convertases
Risk Factors
Serine Endopeptidases
English Statin-associated muscle symptoms (SAMS) are one of the principal reasons for statin non-adherence and/or discontinuation, contributing to adverse cardiovascular outcomes. This European Atherosclerosis Society (EAS) Consensus Panel overviews current understanding of the pathophysiology of statin-associated myopathy, and provides guidance for diagnosis and management of SAMS. Statin-associated myopathy, with significant elevation of serum creatine kinase (CK), is a rare but serious side effect of statins, affecting 1 per 1000 to 1 per 10 000 people on standard statin doses. Statin-associated muscle symptoms cover a broader range of clinical presentations, usually with normal or minimally elevated CK levels, with a prevalence of 7-29% in registries and observational studies. Preclinical studies show that statins decrease mitochondrial function, attenuate energy production, and alter muscle protein degradation, thereby providing a potential link between statins and muscle symptoms; controlled mechanistic and genetic studies in humans are necessary to further understanding. The Panel proposes to identify SAMS by symptoms typical of statin myalgia (i.e. muscle pain or aching) and their temporal association with discontinuation and response to repetitive statin re-challenge. In people with SAMS, the Panel recommends the use of a maximally tolerated statin dose combined with non-statin lipid-lowering therapies to attain recommended low-density lipoprotein cholesterol targets. The Panel recommends a structured work-up to identify individuals with clinically relevant SAMS generally to at least three different statins, so that they can be offered therapeutic regimens to satisfactorily address their cardiovascular risk. Further research into the underlying pathophysiological mechanisms may offer future therapeutic potential.
Language
  • English
Open access status
hybrid
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Persistent URL
https://sonar.ch/global/documents/279720
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