Journal
JOURNAL OF CLINICAL LIPIDOLOGY
Volume 15, Issue 6, Pages 782-788Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacl.2021.09.052
Keywords
Statins; statin intolerance; coronary artery calcium scoring; statin-associated muscle symptoms; Nocebo effect
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Statin therapy can reduce the incidence of cardiovascular events in adults with intermediate or high cardiovascular risk; muscle complaints are the most common reported symptoms; informed clinician-patient discussion and shared decision making are necessary for achieving the best outcomes.
For primary prevention, statin therapy reduces the incidence of atherosclerotic cardiovascular disease (ASCVD) events in adults with intermediate or high estimated 10-year risk using traditional population-based risk calculators. While a variety of reported symptoms may limit statin adherence, muscle complaints, whether typical or atypical of that associated with statin therapy, are the most common reported by patients. Because additional testing, alteration in the patient's medical regimen and subsequent medical visits are often required, an informed clinician-patient discussion and shared decision making are necessary to achieve the best outcomes. The authors provide support for the perspective that coronary calcium scoring, by individualizing estimated risk and helping to identify those most likely to benefit, plays a vital role in preventive therapy decision-making for the primary prevention patient with troublesome muscle complaints attributed to statin therapy. (c) 2021 National Lipid Association. Published by Elsevier Inc. All rights reserved.
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