Обзорная статья

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

Erik S.G. StroesDepartment of Vascular Medicine, Academic Medical Center, Amsterdam, The NetherlandsPaul D. ThompsonHartford Hospital, Hartford, CT, USAAlberto CorsiniUniversity of Milan and Multimedica IRCSS Milano, ItalyGeorgirene D. VladutiuSchool of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USAFrederick J. RaalUniversity of the Witwatersrand, Johannesburg, South AfricaKausik K. RaySt. Georges's University of London, UKMichael RodenDepartment of Endocrinology and Diabetology, University Hospital Düsseldorf Heinrich-Heine University, and Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, GermanyEvan A. SteinMetabolic and Atherosclerosis Research Centre, Cincinnati, OH, USALâle TokgözoğluHacettepe University, Ankara, TurkeyBørge G. NordestgaardHerlev Hospital, Copenhagen University Hospital, University of Copenhagen, DenmarkÉric BruckertPitié-Salpetriere University Hospital, Paris, FranceGuy De BackerGhent University, Ghent, BelgiumRonald M. KraussUlrich LaufsUniversitätsklinikum des Saarlandes, Homburg/Saar, GermanyRaúl D. SantosUniversity of Sao Paulo, BrazilRobert A. HegeleWestern University, London, ON, CanadaG. Kees HovinghAcademic Medical Center, University of Amsterdam, The NetherlandsLawrence A. LeiterLi Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, CanadaFrançois MachWinfried MärzSynlab Center of Laboratory Diagnostics Heidelberg, Heidelberg, GermanyConnie B. NewmanNew York University School of Medicine, New York, USAOlov WiklundSahlgrenska University Hospital, Gothenburg, SwedenTerry A. JacobsonEmory University School of Medicine, Atlanta, GA, USAAlberico L. CatapanoUniversity of Milan and Multimedica IRCSS Milano, ItalyM. John ChapmanINSERM, Pitié-Salpetriere University Hospital, Paris, FranceHenry N. GinsbergColumbia University, New York, USAEuropean Atherosclerosis Society Consensus PanelAcademic Medical CenterPaul D. ThompsonHartford Hospital, Hartford, CT, USAAlberto CorsiniUniversity of Milan and Multimedica IRCSS Milano, ItalyGeorgirene D. VladutiuSchool of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USAEvan A. SteinMetabolic and Atherosclerosis Research Centre, Cincinnati, OH, USAEric BruckertPitié-Salpetriere University Hospital, Paris, FranceRaul D. SantosUniversity of Sao Paulo, BrazilConnie B. NewmanNew York University School of Medicine, New York, USAM. John ChapmanINSERM, Pitié-Salpetriere University Hospital, Paris, FranceHenry N. GinsbergColumbia University, New York, USAM. John ChapmanINSERM, Pitié-Salpetriere University Hospital, Paris, FranceHenry N. GinsbergColumbia University, New York, USATerry A. JacobsonEmory University School of Medicine, Atlanta, GA, USAFrançois MachCardiology Service, HUG, Geneva, Switzerland

2015en

ABI

Аннотация

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.

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Идентификаторы

DOI: 10.1093/eurheartj/ehv043

Цитирования и источники

Цитирований: 2Использованных источников: 0

Показатели — AkademScholar