Attached
OBJECTIVES
Occurrence of muscular symptoms with statin therapy is well-recognized. It could
adversely affect quality of life and exercise tolerance. Objective of this study was to
describe the risk factors for muscular symptoms associated with atorvastatin therapy
in a group of Sri Lankan patients.
METHOD
Consecutive patients receiving atorvastatin at outpatient clinics of a tertiary-care
hospital who were screened for a clinical trial on management of statin myopathy,
were studied. Those with muscle symptoms (pain, tenderness, stiffness, cramps,
weakness) started after initiation of atorvastatin were included. Potential risk factors
were detected with clinical assessment and/or investigations. Details were recorded
using an interviewer administered questionnaire. Data were analysed with SPSS
version-19.0
RESULTS
456 patients were studied; 64.7% were females; mean age was 63.4±10years. 57.5%,
^ . 16.7% and 15.4% had diabetes, hypothyroidism and chronic kidney disease (CKD),
respectively. 46.5% and 45.8% were on lOmg and 20mg of atorvastatin, respectively.
Majority (56%) were on atorvastatin for >48 months. 29.4% had at least one muscle
symptom; 2.9% had elevated creatine phosphokinase. Results of multiple logistic
regression indicated that female gender (OR:1.7; 95% Cl: 1.1-2.9; p=0.03), diabetes
(OR:3.0; 95% Cl: 1.3-6.7; p=0.008) and treatment duration of £48months (OR:2.2;
95% Cl: 1.1-4.8; p=0.04) were independent risk factors for muscular symptoms
associated with atorvastatin therapy. Age, atorvastatin dose, co-medications, history
of hypothyroidism and CKD were not found to be significant risk factors.
CONCLUSION
In the study population, one third had muscular symptoms associated with atorvastatin
therapy; female gender, diabetes and treatment for >48months were independent
risk factors.
