Statin-induced muscular side effects at rest and exercise – An anatomical mapping

Berent, Theresa; Berent, Robert; Steiner, Sabine; Sinzinger, H.

doi:10.1016/j.atherosclerosissup.2019.08.026

Cited by 11 publications

(10 citation statements)

References 30 publications

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“…The results of many trials are still controversial owing to the insufficient evidence from randomized controlled trials (RCTs) and the inconsistent results of the existing studies (Liu et al, 2013 ; Lei et al, 2014 ; Lizza et al, 2014 ; Sikora Newsome et al, 2015 ; Akhigbe et al, 2017 ; Shen et al, 2017 ). In addition, some complications have been reported in patients with aSAH during statin therapy, such as bacteremia, epilepsy, elevated transaminase, and rhabdomyolysis (Magulick et al, 2014 ; Guo et al, 2015 ; Sikora Newsome et al, 2015 ; Berent et al, 2019 ; Nikolic et al, 2020 ). These complications might affect outcomes in patients with aSAH treated with statins.…”

Section: Introductionmentioning

confidence: 99%

“…Statins are believed to relieve cerebral vasospasm (CVS) (Siasios et al, 2013 ; Lizza et al, 2014 ; Sikora Newsome et al, 2015 ). The high-risk period of CVS is 3–14 days after aSAH, with a peak at 6–8 days, and symptomatic CVS usually disappears after 12 days of aSAH (De Backer, 2016 ; Berent et al, 2019 ). Therefore, 2 weeks could be a more reasonable treatment duration.…”

Section: Introductionmentioning

confidence: 99%

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Optimal Course of Statins for Patients With Aneurysmal Subarachnoid Hemorrhage: Is Longer Treatment Better? A Meta-Analysis of Randomized Controlled Trials

et al. 2021

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Statins are used in clinical practice to prevent from complications such as cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (aSAH). However, the efficacy and safety of statins are still controversial due to insufficient evidence from randomized controlled trials and inconsistent results of the existing studies. This meta-analysis aimed to systematically review the latest evidence on the time window and complications of statins in aSAH. The randomized controlled trials in the databases of The Cochrane Library, PubMed, Web of Science, Embase, CNKI, and Wanfang from January 2005 to April 2021 were searched and analyzed systematically. Data analysis was performed using Stata version 16.0. The fixed-effects model (M-H method) with effect size risk ratio (RR) was used for subgroups with homogeneity, and the random-effects model (D-L method) with effect size odds ratio (OR) was used for subgroups with heterogeneity. The primary outcomes were poor neurological prognosis and all-cause mortality, and the secondary outcomes were cerebral vasospasm (CVS) and statin-related complications. This study was registered with PROSPERO (International Prospective Register of Systematic Reviews; CRD42021247376). Nine studies comprising 1,464 patients were included. The Jadad score of the patients was 5–7. Meta-analysis showed that poor neurological prognosis was reduced in patients who took oral statins for 14 days (RR, 0.73 [0.55–0.97]; I2 = 0%). Surprisingly, the continuous use of statins for 21 days had no significant effect on neurological prognosis (RR, 1.04 [0.89–1.23]; I2 = 17%). Statins reduced CVS (OR, 0.51 [0.36–0.71]; I2 = 0%) but increased bacteremia (OR, 1.38 [1.01–1.89]; I2 = 0%). In conclusion, a short treatment course of statins over 2 weeks may improve neurological prognosis. Statins were associated with reduced CVS. Based on the pathophysiological characteristics of CVS and the evaluation of prognosis, 2 weeks could be the optimal time window for statin treatment in aSAH, although bacteremia may increase.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Optimal Course of Statins for Patients With Aneurysmal Subarachnoid Hemorrhage: Is Longer Treatment Better? A Meta-Analysis of Randomized Controlled Trials

et al. 2021

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“…Statin therapy is important for the treatment of atherosclerosis, dyslipidemias, type 2 diabetes, and many cardiovascular diseases. Nonetheless, adverse effects of statin therapy are being increasingly recognized; among them, muscle-related Molecules 2020, 25, 1819 2 of 18 symptoms are rather common [2,3]. Treatment with statins can result in liver function changes secondary to the development of steatohepatitis, especially during the treatment of dyslipidemia in patients with type 2 diabetes [4].…”

Section: Introductionmentioning

confidence: 99%

Hypolipidemic Effects of β-Glucans, Mannans, and Fucoidans: Mechanism of Action and Their Prospects for Clinical Application

et al. 2020

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The search for lipid-lowering drugs is important for clinical medicine. This review summarizes our research findings regarding the hypolipidemic activity of polysaccharides. There are several validated agents altering lipid levels which reduce the risk of atherosclerotic cardiovascular events. Nonetheless, for many people, the risk of such an event remains unacceptably high despite treatment with these agents. This situation has prompted the search for new therapies to reduce the residual cardiovascular risk. The lipid-lowering effect of β-glucans consumed with food was demonstrated in patients with atherosclerosis. The mechanism of the protective effect of β-glucans is poorly studied. The effects of β-glucans are mediated by Toll-like receptors, by dectin-1, and possibly by other receptors. Nevertheless, the mechanism of the protective action of β-glucan in lipemic mice has been studied insufficiently. This review will present up-to-date information regarding experimental hypolipidemic polysaccharide compounds that hold promise for medicine. Phagocyte-specific chitotriosidase in humans contributes to innate immune responses against chitin-containing fungi. This enzyme has been first described in patients with Gaucher disease and serves as an important diagnostic biomarker. It has been reported that, in mice, chitin particles of certain size are recognized by macrophages through Toll-like receptors, dectin-1, and to a lesser extent through mannose receptor.

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“…Physical exercise may also aggravate statin-associated muscle damages, as manifested by elevated plasma levels of muscle-specific enzymes, especially CK [20]. The risk of myopathy is proportional to the degree of physical exertion, so that graded training programs provide time for adaptation of metabolic processes [21]. In the current study, we chose atorvastatin and gemfibrozil because of their frequent coadministration clinically.…”

Section: Discussionmentioning

confidence: 99%

Carvedilol: A Promising Drug Combined With Lipid-lowering Medications for Patients With Hypertension and Heart Failure

Zabihi

Askarian

Moghaddam

et al. 2020

IJT

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Background: Statins frequently cause myopathy especially in combination with fibrates, and physical activity is considered a trigger for the muscle disorder. Elevated plasma levels of creatine kinase (CK), lactate dehydrogenase (LDH) and aldolase, are the main indicators of the severity of myopathy. Carvedilol is commonly used with lipid-lowering drugs in the management of heart failure, hypertension and dyslipidemia. It is not yet clear whether carvedilol, an alpha and β blocker, and anti-oxidant, may influence the development of myopathy when combined with statins and fibrates in cardiac patients. Methods: In this animal experiment, a 10 days regimen containing oral atorvastatin and gemfibrozil at doses of 80 and 1000 mg/kg/day, respectively, was used to induce myopathy in rats. The animals were forced to swim in a pool on days 8, 9 and 10 into the study. Carvedilol (2.5 mg/kg/day) was added to atorvastatin and gemfibrozil during the 10-day study period, in addition to the exercise protocol given to the treatment groups only. The mean of swimming tolerance times and the serum levels of CK, LDH and aldolase were measured at the completion of the study. Results: Carvedilol did not significantly alter the swimming tolerance time or the plasma levels of CK, LDH and aldolase in the rats receiving ATV, GMF and carvedilol plus the exercise protocol, compared with those that did not receive carvedilol (P>0.05). Conclusion: Carvedilol may be used in combination with lipid-lowering drug in the management of patients with heart failure and hypertension, pending its safety approval by clinical studies in humans.

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Statin-induced muscular side effects at rest and exercise – An anatomical mapping

Cited by 11 publications

References 30 publications

Optimal Course of Statins for Patients With Aneurysmal Subarachnoid Hemorrhage: Is Longer Treatment Better? A Meta-Analysis of Randomized Controlled Trials

Optimal Course of Statins for Patients With Aneurysmal Subarachnoid Hemorrhage: Is Longer Treatment Better? A Meta-Analysis of Randomized Controlled Trials

Hypolipidemic Effects of β-Glucans, Mannans, and Fucoidans: Mechanism of Action and Their Prospects for Clinical Application

Carvedilol: A Promising Drug Combined With Lipid-lowering Medications for Patients With Hypertension and Heart Failure

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