Challenging Clinical Issue of Muscle Symptoms in Statin Treated Patients: A Comparison with AHA Guidelines
Objective: To study the frequency of myalgia occurring in Asian population at half or even lower doses of Atorvastatin and Rosuvastatin than latest recommended by American Heart Association.
Methodology: This retrospective cross sectional study included patients undergoing statin therapy with Atorvastatin and Rosuvastatin treated at Rawalpindi Institute of Cardiology, from June to October 2015. Patients were divided into group A receiving 40, 20 and 10mg Atorvastatin and group R receiving20, 10 and 5mg of Rosuvastatin. Interview administered questionnaires were used to collect data regarding their cholesterol profile (mg/dl), statin and its tolerance. For statistical analysis Chi square test was used with p<0.05 was taken as significant.
Results: A total of 500 patients were included with 276 patients in group A and 224 in group R. Most patients 99.4% presented with risk factors of atherosclerotic cardiovascular disease: 84.8% had 2 risk factors and 15.2% had <2 risk factors, necessitating use of statins. A majority of patients experienced myalgia, 80.8% in group A and 83.5% in group R (p<0.05).
Conclusion: This study provides strong evidence that statin lead to frequent muscle related adverse effects and may be challenging in some patients even at lower doses than the recommendation of American Heart Association.
Key Words - Statins, Myalgia, Asian patients, Statin Intolerance