Cardiology Section, Department of Internal Medicine, Faculty of Medicine, University of Jordan; and.
Faculty of Medicine, The University of Jordan, Amman, Jordan.
J Cardiovasc Pharmacol. 2023 Mar 1;81(3):185-191. doi: 10.1097/FJC.0000000000001386.
Statin-associated muscle symptoms (SAMS) are one of the most common side effects of statins. This study aimed to explore the significance of SAMS among statin users by comparing statin users with a control group. To achieve our aims, a propensity score matching the retrospective cohort study was conducted in a single center tertiary hospital. The statin muscle symptoms were assessed using the Proposed Statin Myalgia Index Score, whereas the patient's adherence to medications was evaluated using the Morisky Medication Adherence Scale-8. We included 743 patients in our study; of them, 64.9% were on statin, whereas the rest were controls (35.1%). After propensity score matching, patients on statin had significantly higher rates of SAMS (5.0%) compared with control (1.6%) (AOR = 3.209; 95% CI: 1.020-10.091). However, there was no significant difference between statin users and controls in medications nonadherence ( P -value = 0.820). Our analysis among statins users revealed that moderate-intensity (2.671; 95% CI: 1.691-3.310) and high-intensity (3.552; 95% CI: 2.190-4.129) statin therapy was significantly associated with SAMS. In addition, autoimmune diseases were significantly associated with SAMS occurrence (AOR = 32.301; 95% CI: 1.785-584.374). Also, patients on PPIs had significantly less occurrence of SAMS (AOR = 0.145; 95% CI: 0.044-0.483), whereas patients on antiepileptic drugs had significantly higher SAMS occurrence (AOR = 72.337; 95% CI: 2.649-1975.201). Regarding MACE among statin users, there was no significant difference in the 1-year or 5-year MACE rate between statin users and controls. Our study suggests that SAMS are significant among statin users and must be addressed by health care providers to ensure that patients are still adherent to their medications and hence protected against cardiac events.
他汀类药物相关肌肉症状（SAMS）是他汀类药物最常见的副作用之一。本研究旨在通过比较他汀类药物使用者和对照组来探讨 SAMS 的意义。为了实现我们的目标，我们在一家单中心三级医院进行了回顾性队列研究的倾向评分匹配。他汀类肌肉症状使用建议的他汀类药物肌痛指数评分进行评估，而患者对药物的依从性则使用 Morisky 药物依从性量表-8 进行评估。我们纳入了 743 名患者；其中，64.9%的患者使用他汀类药物，其余为对照组（35.1%）。经过倾向评分匹配后，使用他汀类药物的患者 SAMS 发生率明显高于对照组（5.0%比 1.6%）（AOR=3.209；95%CI：1.020-10.091）。然而，在药物不依从性方面，他汀类药物使用者和对照组之间没有显著差异（P 值=0.820）。我们对他汀类药物使用者的分析表明，中等强度（2.671；95%CI：1.691-3.310）和高强度（3.552；95%CI：2.190-4.129）他汀类药物治疗与 SAMS 显著相关。此外，自身免疫性疾病与 SAMS 的发生显著相关（AOR=32.301；95%CI：1.785-584.374）。此外，使用质子泵抑制剂的患者 SAMS 发生率显著降低（AOR=0.145；95%CI：0.044-0.483），而使用抗癫痫药物的患者 SAMS 发生率显著升高（AOR=72.337；95%CI：2.649-1975.201）。关于他汀类药物使用者的 MACE，他汀类药物使用者和对照组在 1 年或 5 年的 MACE 发生率方面没有显著差异。我们的研究表明，SAMS 在他汀类药物使用者中是显著的，医疗保健提供者必须解决这一问题，以确保患者仍然坚持他们的药物治疗，从而预防心脏事件。
