The Impact of Statin Intolerance in Lipid Clinic Patients
Open accessAbstract
Context: Cardiovascular disease is a very common and serious problem in the western world. Statin drug therapy is used in primary, secondary prevention and familial hypercholesterolemia. However, these are frequently associated with adverse effects, causing poor adherence and thus putting patients at risk for future cardiovascular events. Aim: The objective of this study was to review the statin intolerance in lipid patients and to assess the impact of alternative lipid lowering therapy on lipid parameters and cardiovascular outcome in statin intolerant patients. Methodology: 50 patients attending the out-patient lipid clinic of our hospital with statin intolerance were identified. Clinical data on the study patients were gathered retrospectively relating to statin intolerance and the clinical effectiveness of alternative lipid lowering therapy on lipid parameters and cardiovascular outcome. Results: Rosuvastatin was the most intolerable whereas pravastatin or fluvastatin was the most tolerable statin in our study patients. Myalgia was the commonly reported adverse effect of statin. The low dose statin monotherapy or combination of low dose statin and ezetemibe was the most tolerable alternative lipid lowering therapy in statin intolerant patients. After an average period of 10 months of initiation of alternative lipid lowering therapy; combination of low dose statin plus ezetimibe showed the largest reduction in serum total cholesterol and low-density lipoprotein (LDL) cholesterol levels. Conclusions: Pravastatin should be preferred in statin intolerant patients. A combination of low dose statin plus ezetimibe appeared to be the most tolerable and clinically effective therapy in statin intolerant patients.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Three studies reported the incidence of muscle symptoms, five studies provided data on treatment discontinuation due to muscle symptoms, and eight studies reported on effectiveness.
“Three studies reported the incidence of muscle symptoms [36–38], five studies provided data on treatment discontinuation due to muscle symptoms [36,37,39,42,45], and eight studies reported on effectiveness [35–37,39,41,44,45,50].”
We included eight retrospective cohort studies and two prospective cohort studies.
“We included eight retrospective cohort studies [35,38,39,41,42,44,45,50] and two cohort prospective studies [36,37] (S4 File, Table 2).”
All 8 identified retrospective studies were of low quality, mainly due to concerns regarding residual confounding because of lack of adjustment.
“Notably all 8 identified retrospective studies were of low quality, mainly due to concerns regarding residual confounding because of lack of adjustment (S2 File) [35,36,38,41,42,44,45,50].”
From Safety outcomes of statin vs non-statin lipid-lowering interventions in patients with prior statin-associated muscle symptoms: A systematic review and meta-analysis (2025) · cites this paper as [50]
The Study Design and Setting section describes a retrospective review of 50 lipid-clinic patients, and Study Limitations calls this a small observational study. Neither section assesses eight retrospective studies or attributes low quality to residual confounding from lack of adjustment; searches for those terms found no such assessment in our copy. (LLM, conf=0.75)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Yusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., McQueen, M., Budaj, A., Pais, P., Varigos, J., et al. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17018-9 · Cited by 12,026 · see citing works
Stone, N. J., Robinson, J. G., Lichtenstein, A. H., Bairey Merz, C. N., Blum, C. B., Eckel, R. H., Goldberg, A. C., Gordon, D., Levy, D., Lloyd-Jones, D. M., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437738.63853.7a · Cited by 7,081 · see citing works
Cholesterol Treatment Trialists' (CTT) Collaboration (2010) · The Lancet · doi:10.1016/s0140-6736(10)61350-5 · Cited by 6,550 · see citing works
European cardiovascular disease statistics
Allender, S. E., Scarborough, P., Peto, V., Rayner, M., Leal, J., Luengo-Fernández, R., & Gray, A. M. (2008) · Deakin Research Online (Deakin University) · Cited by 1,459 · see citing works
Statin Safety: A Systematic Review
Law, M., & Rudnicka, A. R. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.12.010 · Cited by 808 · see citing works
JBS3 Board (2014) · Heart · doi:10.1136/heartjnl-2014-305693 · Cited by 608 · see citing works
Hippisley‐Cox, J., & Coupland, C. A. C. (2010) · BMJ · doi:10.1136/bmj.c2197 · Cited by 511 · see citing works
Risk of incident diabetes among patients treated with statins: population based study
Carter, A. A., Gomes, T., Camacho, X., Juurlink, D. N., Shah, B. R., & Mamdani, M. M. (2013) · BMJ · doi:10.1136/bmj.f2610 · Cited by 404 · see citing works
Mills, E. J., WU, P., Chong, G., Ghement, I., Singh, S., Akl, E. A., Eyawo, O., Guyatt, G., Berwanger, O., & Briel, M. (2011) · QJM · doi:10.1093/qjmed/hcq165 · Cited by 338 · see citing works
Current overview of statin-induced myopathy
Rosenson, R. S. (2004) · The American Journal of Medicine · doi:10.1016/j.amjmed.2003.10.033 · Cited by 287 · see citing works
Statin Safety: An Overview and Assessment of the Data—2005
Bays, H. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.12.006 · Cited by 264 · see citing works
An Assessment of Statin Safety by Muscle Experts
Thompson, P. D., Clarkson, P. M., & Rosenson, R. S. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.12.013 · Cited by 263 · see citing works
Lipid-Lowering Drugs and Risk of Myopathy: A Population-Based Follow-Up Study
Gaist, D., Rodríguez, L. A. G., Huerta, C., Hallas, J., & Sindrup, S. H. (2001) · Epidemiology · doi:10.1097/00001648-200109000-00017 · Cited by 210 · see citing works
Mancini, G. B. J., Baker, S. K., Bergeron, J., FITCHETT, D. H., Frohlich, J. J., Genest, J. J., Gupta, M., Hegele, R. A., Ng, D. S., & Pope, J. E. (2011) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2011.05.007 · Cited by 184 · see citing works
Efficacy and safety of pravastatin vs simvastatin after cardiac transplantation
KEOGH, A. M., Macdonald, P. S., Kaan, A., Aboyoun, C. L., Spratt, P. M., & Mundy, J. A. (2000) · The Journal of Heart and Lung Transplantation · doi:10.1016/s1053-2498(00)00077-2 · Cited by 96 · see citing works
Management of Cardiovascular Risk: The Importance of Meeting Lipid Targets
Gotto, A. M., & Moon, J. E. (2012) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2012.04.002 · Cited by 78 · see citing works
Gudzune, K. A., Monroe, A. K., Sharma, R., Ranasinghe, P. D., Chelladurai, Y., & Robinson, K. A. (2014) · Annals of Internal Medicine · doi:10.7326/m13-2526 · Cited by 70 · see citing works
Alberton, M., Wu, P., Druyts, E., Briel, M., & Mills, E. J. (2011) · QJM · doi:10.1093/qjmed/hcr158 · Cited by 66 · see citing works
Evidence-based Use of Statins for Primary Prevention of Cardiovascular Disease
Minder, C. M., Blaha, M. J., Horne, A., Michos, E. D., Kaul, S., & Blumenthal, R. S. (2012) · The American Journal of Medicine · doi:10.1016/j.amjmed.2011.11.013 · Cited by 41 · see citing works
Are Cardiovascular Benefits in Statin Lipid Effects Dependent on Baseline Lipid Levels?
Ferdinand, K. C. (2010) · Current Atherosclerosis Reports · doi:10.1007/s11883-010-0149-9 · Cited by 6 · see citing works
Epidemiology of hyperlipidemia and the efficacy of pravastatin therapy
The Pravastatin Collaborative Study Group (1993) · Current Therapeutic Research · doi:10.1016/s0011-393x(05)80629-0 · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
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
“Notably all 8 identified retrospective studies were of low quality, mainly due to concerns regarding residual confounding because of lack of adjustment (S2 File) [35,36,38,41,42,44,45,50].”
- Authors
- Williams, K., & Mishra, V.
- Affiliations
- University of Liverpool (GB)
- Royal Liverpool and Broadgreen University Hospital NHS Trust (GB)
- Corresponding author
- Mishra, Vinita
- ORCID
- Mishra, Vinita
- Venue
- International Journal of Clinical Medicine
- Publisher
- Scientific Research Publishing, Inc.
- Published
- 2015
- Volume
- 06
- Issue
- 05
- Pages
- 314-321
- ISSN
- 2158-284X (ISSN-L)
- 2158-2882
- OpenAlex
- W1957871379
- Cited by
- 1
- References
- 22
- Citations by year
- 2025: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- International Journal of Clinical Medicine (publishedVersion, cc-by)
- 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 › Blood Pressure and Hypertension Studies
- Keywords
- statin intolerance, statin adverse effects, myalgia, pravastatin, fluvastatin, rosuvastatin, ezetimibe, low-dose statin therapy, lipid clinic patients, LDL cholesterol lowering, total cholesterol, cardiovascular outcomes, medication adherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
