Statins: Review of safety and potential side effects

Abstract

Background: Traditional Framingham risk factors are highly prevalent in patients with chronic kidney disease (CKD); however, they do not completely account for the accelerated cardiovascular (CV) risk in CKD. Recently global longitudinal strain (GLS) has emerged as a superior method for detecting, often subclinical, left ventricular(LV) systolic dysfunction as compared to ejection fraction(EF). This study aimed to determine the relationship between GLS, traditional risk factors and novel CKD-related risk factors in patients with CKD.Methods: This was a cross sectional study of patients with moderate CKD stages 3 and 4 (n=136). Clinical characteristics, anthropometric, biochemical data including markers of inflammation [C-reactive protein (CRP)], novel uraemic toxins [indoxyl sulphate(IS), p-cresyl sulphate(PCS)], and arterial stiffness [pulse wave velocity (PWV)] were measured. Inducible ischaemia was detected using exercise stress echo. Associations between GLS, traditional risk factors and CKDrelated risk factors were explored using multivariate models.Results: The study population parameters included: mean age 59.4±9.8 years, 58% male, estimated glomerular filtration rate (eGFR) 44.4±10 ml/min/1.73m 2 , GLS -18.3±3.6% and EF 65.8%±7.8%. We demonstrated that GLS correlated with diabetes (r=0.21, p=0.01), history of heart failure (HF) (r=0.20, p=0.01), free IS (r=0.24, p=0.005) free PCS (r=0.23, p=0.007), body mass index (BMI) (r=0.28, p<0.001), and PWV (r=0.24, p=0.009). Following adjustment for demographic, baseline co-morbidities and laboratory parameters, GLS was independently associated with free IS, BMI and arterial stiffness (R 2 for model = 0.30, p<0.0001). Conclusion:In the CKD cohort, LV systolic function, assessed using GLS, was associated with novel uraemic toxins, obesity and arterial stiffness.

Manifesting heterozygotes in McArdle disease: a myth or a reality—role of statins

“…Statins are the most widely used drug for the management of hypercholesterolemia. Myotoxicity derived from statin treatment can be manifested as myalgia and weakness, which can be also accompanied by high serum CK levels (Ramkumar et al 2016), with more severe muscular involvement (i.e., rhabdomyolysis) being rare (du Souich et al 2017). The number of people suffering from statin-derived myotoxicity is unclear, but it has been estimated to range from 7 to 29% (du Souich et al 2017).…”

Beneficial Effects of Cornelian Cherries on Lipid Profile and NO/ROS Balance in Obese Zucker Rats: Comparison with CoQ10

“…Second is elevation of NO level by administration of NO donors such as nitroglycerin, nitrosothiols, or mono/dinitrates. And third, probably the most effective approach, is simultaneous ROS reduction and NO stimulation, e.g., by the treatment with angiotensin-converting enzyme inhibitors, AT1-receptor blockers, β-receptor blockers, or statins with NO-increasing properties [3][4][5][6][7]. Actually, statins belong to the first choice in the treatment of cardiovascular and obesity-associated diseases [5,7].…”

“…And third, probably the most effective approach, is simultaneous ROS reduction and NO stimulation, e.g., by the treatment with angiotensin-converting enzyme inhibitors, AT1-receptor blockers, β-receptor blockers, or statins with NO-increasing properties [3][4][5][6][7]. Actually, statins belong to the first choice in the treatment of cardiovascular and obesity-associated diseases [5,7]. Under certain conditions, statin therapy may be however associated with residual risk and several side effects, e.g., locomotion disturbances, nonallergic rhinitis, hyperglycemia, or rhabdomyolysis [7].…”

Assessing the Relationship between Atherosclerotic Cardiovascular Disease Risk Score and Carotid Artery Imaging Findings

“…The expansion of statin treatment eligibility under ACC/AHA guidelines has been controversial . Although statins are generally well tolerated, they have side effects, including myalgias, and are associated with a small but significant increased risk of incident type 2 diabetes …”

“…[8][9][10] Although statins are generally well tolerated, they have side effects, including myalgias, and are associated with a small but significant increased risk of incident type 2 diabetes. 11,12 Vascular imaging is not part of the main 2013 ACC/AHA guidelines, although a coronary artery calcium (CAC) score of ࣙ300 Agatston units or ࣙ75th percentile for age, sex, and ethnicity is mentioned as a specific risk factor in individuals for whom risk assessment is uncertain. 2 Vascular imaging could potentially be performed in more general populations to identify asymptomatic individuals at particularly high risk for cardiac and cerebrovascular events or identify patients with high ASCVD risk scores but low-risk imaging characteristics.…”