Optimizing cholesterol treatment in patients with muscle complaints
Open accessAbstract
Statins are highly effective for preventing cardiovascular events by reducing low-density lipoprotein cholesterol (LDL-C). However, many patients taking statins report muscle-related symptoms that prevent the use of guideline recommended doses. Patients with reported intolerance to statins have a high risk of cardiovascular events. Clinical strategies that optimize cardiovascular risk reduction through LDL-C lowering need to be applied in patients experiencing intolerable side effects that they attribute to statins. In this paper, the authors review definitions of statin intolerance, propose algorithms to better define statin intolerance, and describe approaches to optimize cardiovascular risk reduction among individuals reporting statin-associated muscle symptoms.
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For most patients with statin-associated muscle symptoms, even up to 95%, statins can still be used with a step-by-step approach, because complete statin intolerance affects only 3% to 5% of patients.
“Moreover, for most (even 95%) of the patients with SAMS, it is still possible to use statins using a step-bystep approach, as complete statin intolerance affects only 3% to 5% patients (10)(11)(12).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [10]
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Self-citationEvolocumab in HIV-Infected Patients With Dyslipidemia
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Statin-Induced Myopathy: Translational Studies from Preclinical to Clinical Evidence
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Low-Density Lipoprotein Cholesterol-Lowering Drugs: A Narrative Review
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Self-citationProsarcopenic Effects of Statins May Limit Their Effectiveness in Patients with Heart Failure
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Self-citationStatins: Complex outcomes but increasingly helpful treatment options for patients
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Self-citationEfficacy of Statin Therapy in Patients with Hospital Admission for COVID-19
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Al-Zakwani, I. S., Al-Mahruqi, F., Al‐Rasadi, K., Shehab, A. M., Almahmeed, W. A., Arafah, M., Al-Hinai, A. T., Tamimi, O. A., Alawadhi, M., & Santos, R. D. (2018) · Lipids in Health and Disease · doi:10.1186/s12944-018-0667-y · Cited by 12 · see citing works
Irwin, J. C., Fenning, A. S., Ryan, K., & Vella, R. K. (2018) · Toxicology and Applied Pharmacology · doi:10.1016/j.taap.2018.09.040 · Cited by 12 · see citing works
Pharmacotherapy of the Lipid-Lowering Drugs: Update on Efficacy and Risk
Pierno, S., & Musumeci, O. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24020996 · Cited by 11 · see citing works
Bair, T. L., May, H. T., Knowlton, K. U., Anderson, J. L., LAPPE, D. L., & Muhlestein, J. B. (2020) · Journal of Cardiovascular Pharmacology · doi:10.1097/fjc.0000000000000808 · Cited by 11 · see citing works
Combination effect naringin and pravastatin in lipid profile and glucose in obese rats
Orozco, A. K. R., Ávila-González, A. E., Rodríguez-Razón, C. M., García-Cobián, T. A., Pérez-Guerrero, E. E., García‐Iglesias, T., & Arellano, E. D. R. (2017) · Life Sciences · doi:10.1016/j.lfs.2017.11.044 · Cited by 11 · see citing works
Genetic Variation in Statin Intolerance and a Possible Protective Role for UGT1A1
Willrich, M. A. V., Kaleta, E. J., Bryant, S. C., Spears, G. M., Train, L. J., Peterson, S. E., Lennon, V. A., Kopecky, S. L., & Baudhuin, L. M. (2017) · Pharmacogenomics · doi:10.2217/pgs-2017-0146 · Cited by 11 · see citing works
- Authors
- Rosenson, R. S., Baker, S., Banach, M., Borow, K. M., Braun, L. T., Bruckert, E., Brunham, L. R., Catapano, A. L., Elam, M. B., Mancini, G. B. J., Moriarty, P. M., Morris, P. B., Muntner, P., Ray, K. K., Stroes, E. S., Taylor, B. A., Taylor, V. H., Watts, G. F., & Thompson, P. D.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- McMaster University (CA)
- Medical University of Lodz (PL)
- Rush University Medical Center (US)
- University of Milan (IT)
- University of Tennessee Health Science Center (US)
- University of British Columbia (CA)
- University of Kansas Medical Center (US)
- Medical University of South Carolina (US)
- University of Alabama at Birmingham (US)
- Imperial College London (GB)
- Amsterdam UMC Location University of Amsterdam (NL)
- Hartford Hospital (US)
- University of Toronto (CA)
- The University of Western Australia (AU)
- Corresponding author
- Rosenson, Robert S.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2017-09
- Volume
- 70
- Issue
- 10
- Pages
- 1290-1301
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2745511617
- Cited by
- 193
- References
- 78
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 8 · 2023: 10 · 2022: 12 · 2021: 27 · 2020: 42 · 2019: 29 · 2018: 38 · 2017: 11
- FWCI
- 6.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- HAL (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- statin intolerance, statin-associated muscle symptoms, statins, LDL cholesterol lowering, cardiovascular risk reduction, hypercholesterolemia, diagnostic algorithm
- MeSH terms
- Anticholesteremic Agents, Cardiovascular Diseases, Cholesterol, Humans, Muscular Diseases, Risk Factors, Muscle, Skeletal, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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