The safety of statins in clinical practice

@article{Armitage2007TheSO,
  title={The safety of statins in clinical practice},
  author={Jane Armitage},
  journal={The Lancet},
  year={2007},
  volume={370},
  pages={1781-1790}
}
  • J. Armitage
  • Published 24 November 2007
  • Medicine
  • The Lancet
View on Elsevier
ndph.ox.ac.uk
746 Citations
Highly Influential Citations
33
Background Citations
254
Methods Citations
5
Results Citations
8

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746 Citations

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Safety of statins: an update
Statins are widely used and have been proven to be effective in the prevention of atherosclerotic vascular disease events, primarily by reducing plasma low-density lipoprotein cholesterol…
Non-cardiovascular effects associated with statins
TLDR
Current systematic reviews and clinical practice guidelines indicate that the cardiovascular benefits of statins generally outweigh non-cardiovascular harms in patients above a certain threshold of cardiovascular risk.
Dyslipidemia: Treatment in Statin – Intolerant Patients
TLDR
The first step in handling intolerant patients is to rule out any secondary causes of myopathy or liver toxicity, and the use of non-lipid lowering drugs, such as ezetimibe, bile acids sequestrants and fibrates, alone or in combination are considered.
Statins in the treatment of dyslipidemia in the presence of elevated liver aminotransferase levels: a therapeutic dilemma.
TLDR
This review supports the use of statin treatment in patients with high cardiovascular risk whose elevated aminotransferase levels have no clinical relevance or are attributable to known stable chronic liver conditions.
Statin safety and chronic liver disease
TLDR
There are an increasing number of referrals to both lipid and liver clinics regarding the use of statins in the setting of chronic liver disease and also the cause of elevated liver enzymes in patients who are on statins, and current prescribing strategies in these two patient populations are clarified.
Safety of statins
TLDR
Understanding of the mechanisms behind adverse effects of statins including an insight into the pharmacokinetic properties have minimised fear of statin use among clinicians and awareness of drugs interacting with statins and knowledge of certain combinations together with monitoring of altered creatine kinase activity may greatly minimise associated adverse effects.
Molecular mechanisms of statin intolerance
TLDR
In the case of most patients, it seems that mild-to-moderate abnormalities in liver and muscle enzymes are not serious adverse effects and do not outweigh the benefits of coronary heart disease risk reduction.
Risk identification and possible countermeasures for muscle adverse effects during statin therapy.
Management of statin intolerance
TLDR
Though statin intolerance has considerably impacted cardiovascular outcomes in the high-risk patients, it has been well effectively managed by prescribing statins either as alternate-day or once weekly dosage regimen, as combination therapy with a non-statin therapy or and by dietary intervention.
Statin Safety and Associated Adverse Events: A Scientific Statement From the American Heart Association
TLDR
In patients for whom statin treatment is recommended by current guidelines, the benefits greatly outweigh the risks, and the difference in the incidence of muscle symptoms without significantly raised creatinine kinase in statin-treated compared with placebo-treated participants is <1%, suggesting that muscle symptoms are usually not caused by pharmacological effects of the statin.
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References

SHOWING 1-10 OF 145 REFERENCES
The issue of statin safety: where do we stand?
TLDR
Side effects of statins tend to be dose related, and most side effects, including myopathy, disappear on withdrawal of the medication, although fatalities occasionally occur.
The liver and lovastatin.
  • K. Tolman
  • Medicine
    The American journal of cardiology
  • 2002
Statins and chronic heart failure: do we need a large-scale outcome trial?
Benefits and Risks of HMG-CoA Reductase Inhibitors in the Prevention of Coronary Heart Disease
TLDR
The Scandinavian Simvastatin Survival Study (4S) is the first trial of lipid-lowering therapy to demonstrate an unequivocal reduction in total mortality, and there is now little disagreement on the necessity to reduce low density lipoprotein (LDL) cholesterol effectively in hypercholesterolaemic patients with CHD.
Statin therapy in kidney disease populations: potential benefits beyond lipid lowering and the need for clinical trials
TLDR
Statins appear effective for the prevention of vascular events in people with established vascular disease and mild renal impairment, and may delay renal disease progression in such individuals, but there remains substantial uncertainty regarding the effects of statin therapy among patients with established chronic kidney disease.
Should patients with chronic heart failure be treated with "statins"?
TLDR
An answer to the question of whether or not therapy for CHF should include statins requires a definitive clinical trial, supported by the overriding observation that low plasma lipid levels portend a poorer prognosis in patients with established CHF.
Benefits and risks of HMG-CoA reductase inhibitors in the prevention of coronary heart disease: a reappraisal.
TLDR
The Scandinavian Simvastatin Survival Study (4S) is the first trial of lipid-lowering therapy to demonstrate an unequivocal reduction in total mortality, and there is now little disagreement on the necessity to reduce low density lipoprotein (LDL) cholesterol effectively in hypercholesterolaemic patients with CHD.
MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial
Statin safety: lessons from new drug applications for marketed statins.
  • T. A. Jacobson
  • Biology, Medicine
    The American journal of cardiology
  • 2006
Intensive lipid lowering with atorvastatin in patients with stable coronary disease.
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