Safe use of statins: focus on muscle toxicity

Q Medicine Clinical Lipidology Pub Date : 2016-10-14 DOI:10.1080/17584299.2016.1239873

V. Kolovou, H. Bilianou, G. Kolovou

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引用次数: 6

Abstract

Abstract Muscle toxicity can be classified as myopathy, myalgia, myositis or rhabdomyolysis (RM). RM can occur in patients with muscular dystrophy, alcoholic myopathy, peripheral artery disease and myocardial infarction as well as prolonged convulsions or immobility. Also, RM can occur, in otherwise healthy individuals, after viral illness, crush or high-voltage electrical injury, hyperthermia, severe exercise and taking certain drugs, particularly 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins). Muscle disorders provoked by statin use have been named “statin-associated myopathy (SAM)”. There is no commonly accepted definition of SAM, although recently a score system was introduced and the European Atherosclerosis Society (EAS) proposed a definition of SAM. There are several possible explanations for SAM; for example, genetic predisposition, decreased intracellular cholesterol levels, reduced production of coenzyme Q10 and related ubiquinones and decreased production of prenylated proteins. Due to the widespread use of statins, it is very important to diagnose SAM and particularly its severe presentation, RM. Early treatment will prevent serious complications. This review will focus on SAM.

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他汀类药物的安全使用:关注肌肉毒性

肌肉毒性可分为肌病、肌痛、肌炎或横纹肌溶解(RM)。RM可发生在肌肉萎缩症、酒精性肌病、外周动脉疾病和心肌梗死以及长时间抽搐或不活动的患者。此外，在病毒感染、挤压或高压电损伤、高温、剧烈运动和服用某些药物，特别是3-羟基-3-甲基戊二酰辅酶A (HMG-CoA)还原酶抑制剂(他汀类药物)后，RM也可能发生在其他健康个体中。由他汀类药物引起的肌肉疾病被命名为“他汀相关肌病”。尽管最近引入了一个评分系统，欧洲动脉粥样硬化协会(EAS)提出了SAM的定义，但SAM并没有被普遍接受的定义。对SAM有几种可能的解释;例如，遗传易感性，降低细胞内胆固醇水平，减少辅酶Q10和相关泛醌的产生，减少丙烯酰化蛋白的产生。由于他汀类药物的广泛使用，SAM的诊断非常重要，尤其是其严重的表现，RM。早期治疗可以预防严重的并发症。本文将重点讨论SAM。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Lipidology 生物-生化与分子生物学

CiteScore

0.44

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Clinical Lipidology is published to support the diverse array of medical professionals who work to reduce the incidence of morbidity and mortality from dyslipidemia and associated disorders of lipid metabolism. The Journal''s readership encompasses a broad cross-section of the medical community, including cardiologists, endocrinologists, and primary care physicians, as well as those involved in the treatment of such disorders as diabetes, hypertension, and obesity. The Journal also addresses allied health professionals who treat the patient base described above, such as pharmacists, nurse practitioners and dietitians. Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.