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Review
. 2019 Mar 1;26(3):207-215.
doi: 10.5551/jat.RV17030. Epub 2019 Jan 19.

Diagnosis and Management of Statin Intolerance

Rodrigo Alonso  1 , Ada Cuevas  1 , Alberto Cafferata  2
Affiliations
Review

Diagnosis and Management of Statin Intolerance

Rodrigo Alonso et al. J Atheroscler Thromb. .

Abstract

Statins are the main treatment for hypercholesterolemia and the cornerstone of atherosclerotic cardiovascular disease prevention. Many patients taking statins report muscle-related symptoms, one of the most important causes of statin treatment discontinuation, which is associated with an increased risk of cardiovascular events. Therefore, it is important to identify patients who are truly statin intolerant to avoid unnecessary discontinuation of this beneficial treatment. Some studies indicate that not all muscle complaints are caused by statins, and most patients can tolerate a statin upon re-challenge, down-titration of dose, or switching to another statin. In this paper, we review the definitions of statin intolerance and approaches to reducing cardiovascular risk among individuals reporting statin-associated muscle symptoms.

Keywords: Cardiovascular disease; Myalgia; Myopathy; Statin intolerance; Statins.

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Conflict of interest statement

The authors declare No conflicts of interest.

References

    1. Piepoli M, Hoes A, Agewall S, Albus C, Brotons C, Catapano A, Cooney MT, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FDR, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WMM, Binno S, ESC Scientific Document Group 2016 European Guidelines on cardiovascular disease prevention in clinical practice. The Sixth Joint Task Force of the European Society of Cardiology and other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Eur Heart J, 2016; 37: 2315-2381 - PMC - PubMed
    1. Scandinavian Simvastatin Survival Group. Randomised Trial of cholesterol lowering in 4444 patients with coronary heart disease: The Scandinavian Simvastatin Survival Study (4S). The Lancet, 1994; 344: 1383-1389 - PubMed
    1. Lewis SJ, Moye LA, Sacks FM, Johnstone DE, Timmis G, Mitchell J, Limacher M, Kell S, Glasser SP, Grant J, Davis BR, Pfeffer MA, Braunwald E. Effect of pravastatin on cardiovascular events in older patients with myocardial infarction and cholesterol levels in the average range. Results of the Cholesterol and Recurrent Events (CARE) trial. Ann Intern Med, 1998; 129: 681-689 - PubMed
    1. Heart Protection Study Collaborative Group. Effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20 536 people with cerebrovascular disease or other high-risk conditions. Lancet, 2004; 363: 757-767 - PubMed
    1. LaRosa J, Grundy S, Waters D, Shear C, Barter P, Fruchart JC, Gotto AM, Greten H, Kastelein JJ, Shepherd J, Wenger NK, Treating to New Targets (TNT) Investigators Intensive Lipid Lowering with atorvastatin in patients with stable coronary disease. N Engl J Med, 2005; 352: 1425-1435 - PubMed

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