The Significance of Statin Associated Muscle Symptoms and Its Impact on Patients Adherence and Outcomes.

Statin Associated Muscle Symptoms (SAMS) are one of the most common side effects of statins. This study aimed to explore the significance of SAMS among statin users by comparing statin users with a control group. To achieve our aims, a propensity score matching retrospective cohort study was conducted in a single center tertiary hospital. The statin muscle symptoms were assessed using the Proposed Statin Myalgia Index Score while the patient's adherence to medications was evaluated using Morisky Medication Adherence Scale-8. We included 743 patients in our study, of them 64.9% were on statin while the rest were controls (35.1%). After propensity score matching, patients on statin had significantly higher rates of SAMS (5.0%) compared to control (1.6%) (AOR=3.209; 95%CI: 1.020-10.091). However, there was no significant difference between statin users and controls in medications nonadherence (P-value=0.820). Our analysis among statins users revealed that moderate (2.671; 95%CI: 1.691-3.310) and high (3.552; 95%CI: 2.190-4.129) intensity statin therapy was significantly associated with SAMS. In addition, autoimmune diseases were significantly associated with SAMS occurrence (AOR=32.301; 95%CI: 1.785-584.374). Also, patients on PPIs had significantly less occurrence of SAMS (AOR=0.145; 95%CI: 0.044-0.483) while patients on antiepileptic drugs had significantly higher SAMS occurrence (AOR=72.337; 95%CI: 2.649-1975.201). Regarding MACE among statin users, there was no significant difference in the 1-year or 5- years MACE rate between statin users and controls. Our study suggests that SAMS are significant among statin users and must be addressed by healthcare providers to ensure that patients are still adherent to their medications and hence protected against cardiac events.