From the School of Public Health, Curtin University, Perth, Western Australia, Australia (N.C.W.).
School of Medicine, University of Western Australia, Perth, Australia (N.C.W., G.F.W.).
Circ Res. 2019 Jan 18;124(2):328-350. doi: 10.1161/CIRCRESAHA.118.312782.
There is now overwhelming evidence to support lowering LDL-c (low-density lipoprotein cholesterol) to reduce cardiovascular morbidity and mortality. Statins are a class of drugs frequently prescribed to lower cholesterol. However, in spite of their wide-spread use, discontinuation and nonadherence remains a major gap in both the primary and secondary prevention of atherosclerotic cardiovascular disease. The major reason for statin discontinuation is because of the development of statin-associated muscle symptoms, but a range of other statin-induced side effects also exist. Although the mechanisms behind these side effects have not been fully elucidated, there is an urgent need to identify those at increased risk of developing side effects as well as provide alternative treatment strategies. In this article, we review the mechanisms and clinical importance of statin toxicity and focus on the evaluation and management of statin-associated muscle symptoms.
现在有压倒性的证据支持降低 LDL-c(低密度脂蛋白胆固醇)以减少心血管发病率和死亡率。他汀类药物是一类常用于降低胆固醇的药物。然而,尽管它们被广泛使用,但在动脉粥样硬化性心血管疾病的一级和二级预防中,停药和不遵医嘱仍然是一个主要的空白。他汀类药物停药的主要原因是他汀类药物相关肌肉症状的发展,但也存在一系列其他他汀类药物引起的副作用。尽管这些副作用的机制尚未完全阐明,但迫切需要确定那些发生副作用风险增加的人群,并提供替代治疗策略。在本文中,我们回顾了他汀类药物毒性的机制和临床重要性,并重点评估和管理他汀类药物相关的肌肉症状。