Malani Susheel K, Chigullapalli Sridevi, Sujanyal Saurabh, Sharma Vijay
Cardiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to Be University), Pune, IND.
Medicine and Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to Be University), Pune, IND.
Cureus. 2024 Aug 5;16(8):e66180. doi: 10.7759/cureus.66180. eCollection 2024 Aug.
Statins are one of the most crucial drugs used for the prevention of atherosclerotic coronary artery disease. A wide spectrum of symptoms ranging from myalgia to symptoms of rhabdomyolysis with or without weakness of the upper and lower limbs are indicative of statin-induced rhabdomyolysis or myopathy. The current case series which represents three patients who developed statin-induced myopathy after starting rosuvastatin is one of a few if not the first case series. All three patients had recently started rosuvastatin 40mg once daily post-percutaneous transluminal coronary angioplasty (PTCA) for secondary prevention of atherosclerotic cardiovascular diseases (ASCVDs). Shortly after starting the medication, they were hospitalized due to bilateral lower limb pain and weakness. On further evaluation, they were diagnosed to have rosuvastatin-induced myopathy with acute kidney injury and/or liver injury. In all cases, myopathy, acute renal injury, and liver injury were caused by rosuvastatin, regardless of the presence of a vitamin D deficiency. Despite the documented risk of myopathy and renal toxicity associated with rosuvastatin, the drug remains highly popular worldwide in the modern period. Although all the cases discussed were successfully treated by stopping rosuvastatin and switching it with another class of lipid-lowering agent, it significantly increased morbidity and raised medical expenses. Hence, this case series not only adds to existing safety disputations associated with rosuvastatin but also calls for more pharmacovigilance when recommending this medication.
他汀类药物是预防动脉粥样硬化性冠状动脉疾病最关键的药物之一。从肌痛到横纹肌溶解症状,无论有无上肢和下肢无力,一系列广泛的症状都提示他汀类药物引起的横纹肌溶解或肌病。本病例系列代表了3例在开始服用瑞舒伐他汀后发生他汀类药物引起的肌病的患者,即便不是首个病例系列,也是为数不多的病例系列之一。所有3例患者均在经皮腔内冠状动脉成形术(PTCA)后最近开始每日一次服用40mg瑞舒伐他汀,用于动脉粥样硬化性心血管疾病(ASCVD)的二级预防。开始用药后不久,他们因双侧下肢疼痛和无力住院。进一步评估后,他们被诊断为瑞舒伐他汀引起的肌病,并伴有急性肾损伤和/或肝损伤。在所有病例中,无论是否存在维生素D缺乏,肌病、急性肾损伤和肝损伤均由瑞舒伐他汀引起。尽管有记录表明瑞舒伐他汀存在肌病和肾毒性风险,但在现代,该药物在全球范围内仍然非常受欢迎。虽然所讨论的所有病例通过停用瑞舒伐他汀并换用另一类降脂药物成功得到治疗,但这显著增加了发病率并提高了医疗费用。因此,本病例系列不仅增加了与瑞舒伐他汀相关的现有安全性争议,也在推荐使用这种药物时呼吁加强药物警戒。