Discontinuation of Statins in Routine Care Settings

Abstract

Background-Systematic data on discontinuation of statins in routine practice of medicine are limited.

Assessing potential population impact of statin treatment for primary prevention of atherosclerotic cardiovascular diseases in the USA: population-based modelling study

“… 25 A substantial body of evidence has demonstrated a reduction in incidence and mortality from ASCVD with a good margin of safety from statin therapy, 4 5 25 however, other studies, especially population-based cohort studies, have identified several adverse side effects associated with statins use. 4–10 13 Under the 2013 Guidelines, many US adults are potentially eligible for statin treatment for primary prevention of ASCVD. 2 3 In addition, compared with the ATP III guidelines and current guidelines from other authorities, such as European Society of Cardiology and the European Atherosclerosis Society, 26 27 the ACC/AHA 2013 Guidelines have eliminated LDL-C treatment target values and focused on the specific statin regimens that produce a percentage reduction in LDL-C. One study has summarised the similarities and differences between the ACC/AHA Guidelines and other current guidelines.…”

“…Other adverse side effects associated with statin use might occur. 4–7 9–11 13 37 Increased risk of myopathy and elevation of liver enzymes are two commonly discussed adverse effects. A recent meta-analysis of observational studies found evidence of an increased risk for myopathy, and liver enzyme elevation associated with statin use in addition to type 2 diabetes.…”

“… 38 However, population-based cohort studies show a significantly higher excess incidence of myopathy. 4–6 9 10 13 38 One of the major challenges in the assessment of statin-associated myopathy is the absence of validated definitions. 39 40 Several studies have suggested that the paucity of adverse effects using RCTs might not be generalisable to the population, because patients with complications were often excluded from trials, and the trials tended to have short durations with limited power to detect adverse events.…”

Determining optimal threshold for statins prescribing: individualization of statins treatment for primary prevention of cardiovascular disease

“…However, the patients' preferences are almost invariably different from the panel's as also evident by the fact that as many as 17% of patients discontinue statin therapy despite their doctors' recommendations [30,31]. Thus, the use of statins is a quintessential preference-based decision [32].…”

Körperliche Aktivität in der Rehabilitation nach Myokardinfarkt

“…Wenn es sich um statinassoziierte Muskelbeschwerden handelt, so sollte das jeweilige Statin pausiert werden, um dann mit einer niedrigeren Dosisoder mit einem anderen Präparatneu zu beginnen. Hierdurch können letztlich ≥ 90 % aller Patienten mit Muskelbeschwerden doch mit einem Statin suffizient behandelt werden [42].…”