Myopathy in patients taking atorvastatin: A pilot study

Abstract

Aim:This study aims to investigate the prevalence and risk factors of statin-induced myopathy.Subjects and Methods:A total of 200 patients aged ≥ 40 years and taking atorvastatin 10 mg/day or more for at least 2 weeks were recruited in the study. A detailed history of participants and anthropometry of study participants was recorded, and features of myopathy were explained. Biochemical investigations along with thyroid stimulating hormone (TSH) and Vitamin D were done in all patients.Results:Mean age of study population was 54.81 ± 9.10 years. Sixty-five percent (65.5%) of atorvastatin users had coronary heart disease, 62.5% were hypertensive, 38% had diabetes. Thirty-five percent (35.5%) patients were taking 10 mg/day atorvastatin, 45% were taking 20 mg/day, and 19.5% were taking 40 mg/day. The overall frequency of myopathy among statin users was 7.5% which was significantly higher with increasing dose of atorvastatin (1.4% in 10 mg/day group, 10% in 20 mg/day group, and 12.8% in 40 mg/day, P < 0.05). The frequency of atorvastatin-related myopathy was higher in females 8.65% compared to 6.25% in males. Serum TSH levels in patients with myopathy were 4.05 ± 7.76 μIU/ml while in those without myopathy were 3.13 ± 2.88 μIU/ml (P = 0.649). Serum 25-hydroxy Vitamin D levels were measured in 66 patients randomly. Mean levels in patients with myopathy were 15.98 ± 12.94 ng/ml and without myopathy were 10.20 ± 5.64 ng/ml (P = 0.285).Conclusion:The present study demonstrates that a significantly higher number of patients taking atorvastatin develop myopathy in real life clinical condition. The frequency of myopathy increases with increase in atorvastatin dose.

Effect of short-term physical exercise on serum markers of skeletal muscle damage in hypertensive patients treated with a combination of statin and angiotensin-converting enzyme inhibitor

“…During the treatment with statin, muscle damage was frequently reported, manifested mostly by a muscle pain associated with modest or mild increase in the serum markers of muscle damage, e.g. serum creatine kinase [19][20][21]. No clinical symptoms that might have suggested statin-induced muscle damage were seen in our patients during the study and the physical exercise was very well-tolerated.…”

Correlates of Myopathy in Diabetic Patients Taking Statins

“…To a lower extent, in the same study, diabetes was also identified as a risk factor for rhabdomyolysis (OR 1.96, 95%CI 1.79-2.15) [ 67 ]. Manoj et al found that diabetic patients on atorvastatin had a 7.5% prevalence of myopathy [ 68 ].…”

“…Nonetheless, all the guidelines agree on ordering diagnostic tests based on myopathic symptoms experienced by the patients. Checking serum CK levels is recommended if a patient experiences muscular side effects [ 68 ]. Furthermore, the amount of CK elevation also guides therapy.…”

“…However, the consensus of different guidelines varies regarding serum CK levels ranging from three to 10 times ULN. They recommend stopping statin unless the patient reports symptom improvement [ 68 ].…”

Analysis of Safety Issues of Using Statins in Patients with Diabetes and Hypothyroidism

“…Уровень ТТГ хотя и был в среднем выше в группе пациентов, имеющих признаки миопатии (4,05 ± 7,76 и 3,13 ± 2,88 мЕд/л), одна ко не достигал статистически значимой разницы (р > 0,05). Можно предположить, что отсутствие существенных различий обусловлено малой вы боркой пациентов [27].…”