Ma Ming-Ming, Xu Yao-Yao, Sun Li-Hua, Cui Wen-Jie, Fan Miao, Zhang Su, Liu Lei, Wu Ling-Zhi, Li Liu-Cheng
Department of Diagnostic Ultrasound & Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, People's Republic of China.
Department of Pharmacy, The People's Hospital of Pingyang, Wenzhou, 325400, People's Republic of China.
Int J Gen Med. 2024 May 11;17:2055-2063. doi: 10.2147/IJGM.S460305. eCollection 2024.
Surveillance of drug safety is an important aspect in the routine medical care. Adverse events caused by real-world drug utilization has become one of the leading causes of death and an urgent issue in the field of toxicology. Cardiovascular disease is now the leading cause of fatal diseases in most countries, especially in the elderly population who often suffer from multiple diseases and need long-term multidrug therapy. Among which, statins have been widely used to lower bad cholesterol and regress coronary plaque mainly in patients with hyperlipidemia and atherosclerotic cardiovascular diseases (ASCVD). Although the real-world benefits of statins are significant, different degrees and types of adverse drug reactions (ADR) such as liver dysfunction and muscle injury, have a great impact on the original treatment regimens as well as the quality of life. This review describes the epidemiology, mechanisms, early identification and post-intervention of statin-associated liver dysfunction and muscle injury based on the updated clinical evidence. It provides systematic and comprehensive guidance and necessary supplement for the clinical safety of statin use in cardiovascular diseases.
药物安全监测是日常医疗护理中的一个重要方面。现实世界中药物使用引起的不良事件已成为主要死因之一,也是毒理学领域的一个紧迫问题。心血管疾病目前是大多数国家致死性疾病的主要原因,尤其是在经常患有多种疾病且需要长期多种药物治疗的老年人群中。其中,他汀类药物已广泛用于降低坏胆固醇和使冠状动脉斑块消退,主要用于高脂血症和动脉粥样硬化性心血管疾病(ASCVD)患者。尽管他汀类药物在现实世界中的益处显著,但不同程度和类型的药物不良反应(ADR),如肝功能障碍和肌肉损伤,对原治疗方案以及生活质量都有很大影响。本综述基于最新临床证据描述了他汀类药物相关肝功能障碍和肌肉损伤的流行病学、机制、早期识别及干预后情况。它为心血管疾病中他汀类药物使用的临床安全性提供了系统全面的指导和必要补充。