Statin induced myopathy risk factors
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby
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Overview
Several risk factors predispose to statin induced myopathy. Some of the intrinsic risk factors are advanced age, genetic predisposition, diabetes, hypertension, hypothyroidism and renal diseases. Other extrinsic factors play a role in statin induced myopathy, including alcohol consumption, vitamin D deficiency, excessive exercise, trauma or concomitant use of other drugs like fibrates mainly gemfibrosil, protease inhibitors and macrolide antibiotics.
Risk Factors
Intrinsic Risk Factors
- Advanced age (> 80 years)[1]
- Carnitine palmityl transferase II deficiency
- Diabetes mellitus
- Genetic polymorphisms of CYP450 isoenzymes (single nucleotide polymorphism of the gene SLCO1B1)[2]
- Hepatic disease
- Hypertension
- Hypothyroidism
- McArdle disease
- Metabolic muscle disease
- Myadenylate deaminase deficiency[3]
- Renal disease
- Small body mass index[1]
Extrinsic Risk Factors
- Alcohol consumption
- Amiodarone
- Azole antifungals
- Cyclosporins
- Fibrates particularly gemfibrozil (Cerivastatin in combination with gemfibrosil)[4]
- Grapefruit juice (> 1quart/day)
- Heavy exercise
- High dose of statin[2]
- Macrolide antibiotics
- Major trauma[4]
- Polypharmacy[2]
- Protease inhibitors[3]
- Surgery[4]
- Warfarin
References
- ↑ 1.0 1.1 Venero CV, Thompson PD (2009). "Managing statin myopathy". Endocrinol Metab Clin North Am. 38 (1): 121–36. doi:10.1016/j.ecl.2008.11.002. PMID 19217515.
- ↑ 2.0 2.1 2.2 Harper CR, Jacobson TA (2010). "Evidence-based management of statin myopathy". Curr Atheroscler Rep. 12 (5): 322–30. doi:10.1007/s11883-010-0120-9. PMID 20628837.
- ↑ 3.0 3.1 Toth PP, Harper CR, Jacobson TA: Clinical characterization and molecular mechanisms of statin myopathy. Expert Rev Cardiovasc Ther 2008, 6:955–969
- ↑ 4.0 4.1 4.2 Hamilton-Craig I (2001). "Statin-associated myopathy". Med J Aust. 175 (9): 486–9. PMID 11758079.