Clinical and psychological factors in coronary heart disease patients with statin associated muscle side-effects.
Adult
Aged
Aged, 80 and over
Atorvastatin
/ adverse effects
Coronary Disease
/ diagnosis
Cross-Over Studies
Cross-Sectional Studies
Double-Blind Method
Dyslipidemias
/ diagnosis
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ adverse effects
Male
Middle Aged
Muscular Diseases
/ chemically induced
Norway
/ epidemiology
Prevalence
Risk Factors
Treatment Outcome
Atorvastatin
Beliefs in medicine
Coronary heart disease
Crossover trial
Placebo-controlled
Psychological factors
Statin-associated muscle symptoms
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
16 12 2021
16 12 2021
Historique:
received:
06
04
2021
accepted:
06
12
2021
entrez:
17
12
2021
pubmed:
18
12
2021
medline:
1
2
2022
Statut:
epublish
Résumé
To compare clinical and psychological factors among patients with self-perceived statin-associated muscle symptoms (SAMS), confirmed SAMS, and refuted SAMS in coronary heart disease patients (CHD). Data were obtained from a cross-sectional study of 1100 CHD outpatients and a study of 71 CHD outpatients attending a randomized, double-blinded, placebo-controlled, crossover study to test effects of atorvastatin 40 mg/day on muscle symptom intensity. Clinical and psychosocial factors were compared between patients with and without SAMS in the cross-sectional study, and between patients with confirmed SAMS and refuted SAMS in the randomized study. Bilateral, symmetric muscle symptoms in the lower extremities during statin treatment were more prevalent in patients with confirmed SAMS compared to patients with refuted SAMS (75% vs. 41%, p = 0.01) in the randomized study. No significant differences in psychological factors (anxiety, depression, worry, insomnia, type D personality characteristics) were detected between patients with and without self-perceived SAMS in the cross-sectional study, or between patients with confirmed SAMS and refuted SAMS, in the randomized study. Patients with confirmed SAMS more often present with bilateral lower muscle symptoms compared to those with refuted SAMS. Psychological factors were not associated with self-perceived SAMS or confirmed SAMS. A careful pain history and a search for alternative causes of muscle symptoms are likely to promote communication in patients with SAMS, and may reduce the risk for statin discontinuation.
Sections du résumé
BACKGROUND
To compare clinical and psychological factors among patients with self-perceived statin-associated muscle symptoms (SAMS), confirmed SAMS, and refuted SAMS in coronary heart disease patients (CHD).
METHODS
Data were obtained from a cross-sectional study of 1100 CHD outpatients and a study of 71 CHD outpatients attending a randomized, double-blinded, placebo-controlled, crossover study to test effects of atorvastatin 40 mg/day on muscle symptom intensity. Clinical and psychosocial factors were compared between patients with and without SAMS in the cross-sectional study, and between patients with confirmed SAMS and refuted SAMS in the randomized study.
RESULTS
Bilateral, symmetric muscle symptoms in the lower extremities during statin treatment were more prevalent in patients with confirmed SAMS compared to patients with refuted SAMS (75% vs. 41%, p = 0.01) in the randomized study. No significant differences in psychological factors (anxiety, depression, worry, insomnia, type D personality characteristics) were detected between patients with and without self-perceived SAMS in the cross-sectional study, or between patients with confirmed SAMS and refuted SAMS, in the randomized study.
CONCLUSIONS
Patients with confirmed SAMS more often present with bilateral lower muscle symptoms compared to those with refuted SAMS. Psychological factors were not associated with self-perceived SAMS or confirmed SAMS. A careful pain history and a search for alternative causes of muscle symptoms are likely to promote communication in patients with SAMS, and may reduce the risk for statin discontinuation.
Identifiants
pubmed: 34915854
doi: 10.1186/s12872-021-02422-7
pii: 10.1186/s12872-021-02422-7
pmc: PMC8680044
doi:
Substances chimiques
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Atorvastatin
A0JWA85V8F
Types de publication
Comparative Study
Journal Article
Observational Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
596Informations de copyright
© 2021. The Author(s).
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