Statin-Associated Myopathy: Emphasis on Mechanisms and Targeted Therapy.
Pierandrea VinciEmiliano PanizonLetizia Maria TosoniCarla CerratoFederica PellicoriFilippo MearelliChiara BiasinuttoNicola FiottiFilippo Giorgio Di GirolamoGianni BioloPublished in: International journal of molecular sciences (2021)
Hyperlipidemia is a major risk factor for cardiovascular morbidity and mortality. Statins are the first-choice therapy for dyslipidemias and are considered the cornerstone of atherosclerotic cardiovascular disease (ASCVD) in both primary and secondary prevention. Despite the statin-therapy-mediated positive effects on cardiovascular events, patient compliance is often poor. Statin-associated muscle symptoms (SAMS) are the most common side effect associated with treatment discontinuation. SAMS, which range from mild-to-moderate muscle pain, weakness, or fatigue to potentially life-threatening rhabdomyolysis, are reported by 10% to 25% of patients receiving statin therapy. There are many risk factors associated with patient features and hypolipidemic agents that seem to increase the risk of developing SAMS. Due to the lack of a "gold standard", the diagnostic test for SAMS is based on a clinical criteria score, which is independent of creatine kinase (CK) elevation. Mechanisms that underlie the pathogenesis of SAMS remain almost unclear, though a high number of risk factors may increase the probability of myotoxicity induced by statin therapy. Some of these, related to pharmacokinetic properties of statins and to concomitant therapies or patient characteristics, may affect statin bioavailability and increase vulnerability to high-dose statins.
Keyphrases
- cardiovascular disease
- cardiovascular events
- coronary artery disease
- high dose
- risk factors
- case report
- cardiovascular risk factors
- type diabetes
- skeletal muscle
- climate change
- chronic pain
- low dose
- acute kidney injury
- neuropathic pain
- adipose tissue
- protein kinase
- cell therapy
- pain management
- late onset
- stem cells
- physical activity
- insulin resistance
- mesenchymal stem cells
- decision making