Statin myopathy

Radcliffe, Kristofer A.; Campbell, W. W.

doi:10.1007/s11910-008-0011-4

Cited by 33 publications

(34 citation statements)

References 48 publications

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“…These effects result from impaired protein prenylation, deficiency of coenzyme Q involved in mitochondrial electron transport, genetic varia-*Address correspondence to this author at the Halberg Hospital and Research Institute, Civil Lines, Moradabad-10(UP)244001, India; Tel/Fax: 0091 591 2417437; E-mail: icn2005@sancharnet.in tions and antioxidant protection, abnormal protein glycosylation due to dolichol shortage, or deficiency of selenoproteins [1][2][3][4][5][6][7]. Statins inhibit 3-hydroxy-3-methylglutarylcoenzyme A (HMG-CoA) reductase, the rate-limiting enzyme in cholesterol biosynthesis, which converts HMG-CoA to mevalonate.…”

Section: Introductionmentioning

confidence: 99%

“…Statins inhibit 3-hydroxy-3-methylglutarylcoenzyme A (HMG-CoA) reductase, the rate-limiting enzyme in cholesterol biosynthesis, which converts HMG-CoA to mevalonate. Statins lower plasma low-density lipoprotein (LDL) cholesterol by causing intracellular cholesterol depletion and upregulating the expression of LDL receptors [4][5][6][7]. Apart from cholesterol, mevalonate is also the substrate for the synthesis of nonsteroid isoprenoids including farnesylpy-rophosphate, geranylgeranylpyrophosphate (both attached to small GTP-binding proteins by protein prenyltransferases), coenzyme Q, dolichol, isopentenyladenosine, etc.…”

Section: Introductionmentioning

confidence: 99%

“…Less common adverse effects include hepatotoxicity, peripheral neuropathy, impaired myocardial contractility and autoimmune diseases [5][6][7]. The risk of these unfavorable effects is largely outweighed by marked reduction of cardiovascular events in statin users.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Manifestations of Adverse Effects of Statins, Oxidative Stress and Possible Role of Antioxidants in Prevention?

Fedačko¹,

Singh²,

Chaithiraphan³

et al. 2010

TONUTRAJ

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Abstract:Background: There is evidence that statins are potent and effective agents with several pleiotropic effects for treatment of coronary artery disease(CAD). Statin may have adverse effects, if given in higher doses and in combinations.Methods: Internet search till 2009 and discussion with colleagues.Results: Statins are wonder drugs influencing wide range of physiological, biochemical,and biological functions.This list appears to be quite large and includes hypolipidemic, vasodilative, antithrombotic, antioxidant, antiinflammatory, antiproliferative, anticoagulant, agiogenic and bone formation inducing functions. Myopathy is the most frequent side effect of statins and in some cases may have a form of severe rhabdomyolysis. Less common adverse effects include hepatotoxicity, peripheral neuropathy, impaired myocardial contractility and autoimmune diseases. Rare manifestations of statin intolerance may be; pulmonary, psychiatric, ophthalmic and amyotropic lateral sclerosis. The risk of these unfavorable effects is largely outweighed by great reduction of cardiovascular events in statin users. The spectrum of statin-related myopathy ranges from common but clinically benign myalgia to rare but life-threatening rhabdomyolysis. Observational studies suggest that myalgia can occur in up to 10% of persons prescribed statins, whereas rhabdomyolysis continues to be rare. The mechanisms of statin-related myopathy are unclear. The criteria of diagnosis of myopathy do not bother about the symptoms of patients and oxidative stress, in absence of raised muscle enzymes.Coenzyme Q10 and other antioxidants are not considered in the prophylaxis of statin toxicity. Because one study showed no decrease in CoQ in the muscle in presence of toxicity, although several studies indicate a reduction in serum levels. Conclusion:Statins would be used more commonly in near future due to their cholesterol lowering and antiinflammatory effects. There would be a marked increase in the Number of patients with statin toxicity. Several studies have reported a significant reduction in the serum CoQ in patients receiving statins.Such concern has also been expressed by the International College of Cardiology in their meeting in April 2002April and 2005April and 2009, proposing that coenzyme Q10 and other antioxidants should be considered in the prevention as well as treatment of statin intoxication.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Manifestations of Adverse Effects of Statins, Oxidative Stress and Possible Role of Antioxidants in Prevention?

Fedačko¹,

Singh²,

Chaithiraphan³

et al. 2010

TONUTRAJ

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“…On the other hand, adverse effects of statins could have serious impact and form a significant barrier to therapy adherence. A variety of muscle-related side effects could occur [3][4].…”

Section: Introductionmentioning

confidence: 99%

A case of myositis with immunological background associated with statin use

Protić

Baltić²,

Stupar

et al. 2014

Open Medicine

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AbstractStatins might cause and/or aggravate the immune-mediated myositis in patients on long-term, stable treatment. We provide a case of polymyositis with an immunological background and gastrointestinal and urinary manifestations in patient on long-term, stable atorvastatin treatment for the past six years. The diagnose of polymyositis was established based on clinical symptoms and signs, electromyography and laboratory test results (elevated aspartate aminotransferase 279 U/L, reference range 0–40 U/L; alanine aminotransferase 198 U/L, 0–33 U/L; lactate dehydrogenase 2200 U/L, 103-227 U/L; creatine kinase 7820 U/L, 15–84 U/L; and positive antinuclear antibodies test, titer of 1:160, with suspect antisynthetase antibodies). Polymyositis was probably related to atorvastatin treatment (Naranjo score, 5). Other probable causes of the myositis were rejected. Coricosteroid therapy, methotrexate and supplementation with vitamin D did not improve the condition. The patient remained bedridden and died two months after the hospital discharge due to the acute myocardial infarction.

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“…Myopathy may be defined by a ten-fold elevation in creatine kinase (CK) with muscle pain or weakness, while rhabdomyolysis is usually associated with CK >10,000 international units per litre (IU/l) and acute kidney injury, which may be lifethreatening. [1][2][3][4][5][6][7][8] The placebo-corrected incidence of rhabdomyolysis in a systematic review of 20 statin trials was 1.6/100,000 per year, 9 but the incidence is likely to be higher than this in everyday clinical practice when statins are knowingly or inadvertently co-prescribed with drugs that inhibit their metabolism. 10 Against this background we wish to report a case of rhabdomyolysis that occurred when fusidic acid was co-prescribed with atorvastatin, potentiating the toxicity of both drugs.…”

Section: Introductionmentioning

confidence: 99%