Abstract
Objective Statins are the most commonly used cholesterol-lowering drugs to reduce cardiovascular risks. Elevation of serum creatine kinase (CK) activity with or without myopathy constitutes the most common forms of statin intolerance. We aimed to examine the frequency of statin-associated symptomatic and asymptomatic myopathy among consecutive patients with hyperCKemia. Methods We performed a retrospective review of electronic and paper medical records and selected 1,278 consecutive patients with hyperCKemia who were treated from 2013 to 2016 at the (undisclosed). We evaluated potential causes of hyperCKemia and analyzed specifically records of statin users by collecting demographic data, medical history, neuromuscular examination and biochemical profiles. Results In all, 290 (22.7%) patients with hyperCKemia were statin users, and among them, 79 (43.9%, or 6.2% of total) were considered to be due to statin exposure after normalization of serum CK activity with statin discontinuation (88.6% were asymptomatic). The mean age was 58.6 years (range 26-95) and 26.6% were women. Only 9 (11.4%) patients had symptomatic hyperCKemia with myopathy syndrome. The mean serum CK activity with statin exposure was 326.3±150 IU/L (normal reference: 30-223 IU/L) and 198.6±82.9 IU/L after statin discontinuation. Atorvastatin (74.7%) was the most commonly used statin, followed by pravastatin (11.4%) and simvastatin (7.6%). In all, 41 (51.9%) patients had type 2 diabetes mellitus (T2D), 55 (69.6%) had chronic kidney disease (CKD), 7 (8.9%) had chronic liver disease, 15 (19%) hypothyroidism and 4 (5.1%) had HIV infection. Conclusion Our study suggests that statins exposure is a common cause of hyperCKemia, but that the great majority of cases are asymptomatic. Further studies are necessary to clarify whether T2D and CKD are independent risk factors for hyperCKemia or epiphenomena to statins indications. Reference Chatzizisis, Y.S., Koskinas, K.C., Misirli, G. et al. Drug-Safety (2010) 33: 171.
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