TY - JOUR
T1 - Statin-associated adverse events
AU - Yuet, Wei Cheng
AU - Khine, Htet
AU - Ahmad, Zahid
N1 - Publisher Copyright:
© the authors, publisher and licensee Libertas Academica Limited.
PY - 2015/7/7
Y1 - 2015/7/7
N2 - Although statins are well tolerated, their widespread use has raised awareness of rare adverse events. For example, the United States Food and Drug Administration (FDA) has issued product label warnings about statin-associated myopathy, incident diabetes, and cognitive impairment. Addi-tional statin-associated adverse effects include proteinuria, transaminitis, and hemorrhagic stroke. The underlying pathophysiology of these adverse events remains unclear, and thus little guidance exists on addressing these issues at the bedside. Although statin-associated myopathy is common, many patients eventually tolerate a statin – albeit at less than ideal doses. Incident diabetes remains difficult to predict, but high statin potency, increasing age, and pre-existing diabetes risk factors may predispose patients. Cognitive impairment – described mostly in case reports – may resolve after discontinuation of the offending statin. Rosuvastatin is linked to dose-dependent proteinuria. Elevated transaminases are reversible and unlikely to cause severe consequences. History of cerebrovascular disease increases the risk of hemorrhagic stroke on statin therapy. Overall, a thorough understanding of statin-associated adverse events will help health care providers manage patients who develop these complications. Here, we review the evidence for several statin-associated adverse effects and the implications for clinical practice.
AB - Although statins are well tolerated, their widespread use has raised awareness of rare adverse events. For example, the United States Food and Drug Administration (FDA) has issued product label warnings about statin-associated myopathy, incident diabetes, and cognitive impairment. Addi-tional statin-associated adverse effects include proteinuria, transaminitis, and hemorrhagic stroke. The underlying pathophysiology of these adverse events remains unclear, and thus little guidance exists on addressing these issues at the bedside. Although statin-associated myopathy is common, many patients eventually tolerate a statin – albeit at less than ideal doses. Incident diabetes remains difficult to predict, but high statin potency, increasing age, and pre-existing diabetes risk factors may predispose patients. Cognitive impairment – described mostly in case reports – may resolve after discontinuation of the offending statin. Rosuvastatin is linked to dose-dependent proteinuria. Elevated transaminases are reversible and unlikely to cause severe consequences. History of cerebrovascular disease increases the risk of hemorrhagic stroke on statin therapy. Overall, a thorough understanding of statin-associated adverse events will help health care providers manage patients who develop these complications. Here, we review the evidence for several statin-associated adverse effects and the implications for clinical practice.
KW - Cognitive impairment
KW - Diabetes risk
KW - HMG-CoA reductase inhibitor
KW - Myopathy
KW - Statin
UR - http://www.scopus.com/inward/record.url?scp=84940190945&partnerID=8YFLogxK
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U2 - 10.4137/CMT.S18865
DO - 10.4137/CMT.S18865
M3 - Review article
AN - SCOPUS:84940190945
SN - 1179-559X
VL - 7
SP - 17
EP - 24
JO - Clinical Medicine Insights: Therapeutics
JF - Clinical Medicine Insights: Therapeutics
ER -