Qi Guanming, Rao Aaida, Tariq Sara, Diaz Ledesma Lizeth
Internal Medicine, Guthrie Lourdes Hospital, Binghamton, USA.
Cureus. 2025 Jun 17;17(6):e86246. doi: 10.7759/cureus.86246. eCollection 2025 Jun.
Statin-associated muscle symptoms (SAMS) are a common side effect of statin therapy, which is widely used to manage cardiovascular diseases (CVDs). These symptoms, which can range from mild muscle discomfort to more severe complications, may lead some patients to discontinue statin therapy, potentially affecting cardiovascular risk management. We present the case of a 67-year-old male patient with multiple cardiovascular comorbidities, including peripheral artery disease (PAD), who developed SAMS after resuming rosuvastatin. Management included statin discontinuation, supportive care with intravenous fluids, and transition to a non-statin lipid-lowering agent (proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor). This case highlights the diagnostic and therapeutic challenges of managing SAMS in a patient with complex cardiovascular comorbidities, particularly focusing on distinguishing myopathy from ischemic symptoms and navigating statin reintroduction versus alternative lipid-lowering strategies.
他汀类药物相关肌肉症状（SAMS）是他汀类药物治疗的常见副作用，他汀类药物广泛用于管理心血管疾病（CVD）。这些症状范围从轻度肌肉不适到更严重的并发症，可能导致一些患者停止他汀类药物治疗，从而可能影响心血管风险管理。我们报告一例67岁男性患者，患有多种心血管合并症，包括外周动脉疾病（PAD），在恢复使用瑞舒伐他汀后出现了SAMS。治疗措施包括停用他汀类药物、静脉输液支持治疗以及改用非他汀类降脂药物（前蛋白转化酶枯草溶菌素/kexin 9型（PCSK9）抑制剂）。该病例突出了在患有复杂心血管合并症的患者中管理SAMS的诊断和治疗挑战，特别是在区分肌病与缺血症状以及确定他汀类药物重新引入与替代降脂策略方面。
