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The prevalence of statin intolerance worldwide: a systematic review and meta-analysis with 4,143,517 patients
Abstract
Background The efficacy of statins in the prevention and treatment of cardiovascular disease is well established. Despite their large benefit, statin intolerance (SI) is still an important clinical challenge. In this meta-analysis, we aimed to estimate the overall prevalence of SI, the prevalence based on different diagnostic criteria and different disease settings. Methods We searched all electronic databases until the end of March 2021 for studies that reported the prevalence of SI. The primary endpoint was overall prevalence and prevalence based on different diagnostic criteria (National Lipid Association/NLA, International Lipid Expert Panel/ILEP and European Atherosclerosis Society/EAS). The secondary endpoint was the SI prevalence in the groups of patients with different diseases' settings. A random-effects model was applied to estimate the overall pooled prevalence. Results One hundred and seventy-six studies (112 RCTs; 64 cohort studies) with 4,143,517 patients were included in the analysis. The overall SI prevalence was 9.1% (8.1 to 10%). The prevalence based on NLA criteria was similar compared to ILEP and EAS (7.0, 6.7, 5.9%, respectively; p>0.05). The prevalence of SI in RCTs studies was significantly lower in comparison to the cohort studies (4.9 vs. 17%; p<0.001). The SI prevalence in patients both in primary and secondary prevention was much higher (18%; mainly due to dominant cohort studies) than in the separate analysis of those in primary and secondary preve…
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“However the prevalence of statin-associated muscle symptoms varies across populations and is influenced by factors such as female sex, older age, obesity, and statin intensity [6].”
In the citing paper
“Nevertheless SAMS is a common adverse effect occurring in approximately 10% (95% CI: 8.1–10%) of patients taking a statin.”
In the citing paper
“This variability is evident in the current guidelines, which mostly rely on expert opinions. [6,9].”
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Aebi, P. S., Villoz, F., Bührer, J., Lyko, C., Abolhassani, N., Del Giovane, C., Gencer, B., Rodondi, N., & Blum, M. R. (2025) · PLOS One · doi:10.1371/journal.pone.0338575
Metadata
- Authors
- Bytyci, I., Bajraktari, G., Sahebkar, A., Penson, P. E., Rysz, R., & Banach, M. Y.
- Affiliations
- University Clinical Centre of Kosova, Clinic of Cardiology, Pristina, Kosovo Republic of
- University Clinical Center of Kosovo (XK)
- Polish Mother’s Memorial Hospital Research Institute (PL)
- Institute of Cardiovascular Medicine & Science of Liverpool, Liverpool, United Kingdom
- Medical University of Lodz (PL)
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-10-01
- Volume
- 42
- Issue
- Supplement_1
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W4316924354
- Cited by
- 5
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2022: 1 · 2021: 2
- FWCI
- 0.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- European Heart Journal (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Keywords
- statin intolerance, prevalence, diagnostic criteria, primary prevention, secondary prevention, familial hypercholesterolemia, hypercholesterolemia, dyslipidemia, diabetes mellitus, coronary artery disease, acute coronary syndrome, myocardial infarction, statins, lipid-lowering therapy
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