期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 67, 期 20, 页码 2395-2410出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2016.02.071
关键词
interstitial lung disease; myopathy; rhabdomyolysis; skeletal muscle
Hydroxy-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors or statins are well tolerated, but associated with various statin-associated symptoms (SAS), including statin-associated muscle symptoms (SAMS), diabetes mellitus (DM), and central nervous system complaints. These are statin-associated symptoms because they are rare in clinical trials, making their causative relationship to statins unclear. SAS are, nevertheless, important because they prompt dose reduction or discontinuation of these life-saving mediations. SAMS is the most frequent SAS, and mild myalgia may affect 5% to 10% of statin users. Clinically important muscle symptoms, including rhabdomyolysis and statin-induced necrotizing autoimmune myopathy (SINAM), are rare. Antibodies against HMG-CoA reductase apparently provoke SINAM. Good evidence links statins to DM, but evidence linking statins to other SAS is largely anecdotal. Management of SAS requires making the possible diagnosis, altering or discontinuing the statin treatment, and using alternative lipidlowering therapy. (C) 2016 by the American College of Cardiology Foundation.
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