Statin use impairs muscle strength recovery in post‐stroke patients with sarcopenia

Abstract

AimThe effects of statins on muscle health are not well established. Therefore, this study investigated the impact of statin use on muscle strength and mass recovery in patients with sarcopenia after stroke.MethodsThis retrospective cohort study included stroke patients with sarcopenia hospitalized between 2015 and 2021 at a post‐acute rehabilitation hospital. Sarcopenia was diagnosed using handgrip strength and skeletal muscle mass index measured using bioelectrical impedance analysis according to the 2019 criteria of the Asian Working Group for Sarcopenia. The study outcomes included handgrip strength and skeletal muscle mass index at hospital discharge. We used multivariate analyses to examine whether statin use was independently associated with the outcomes. Statistical significance was set at P < 0.05.ResultsOf the 586 patients enrolled, 241 (mean age 79.3 years, 44.4% men) presented with sarcopenia and were included in the analysis. Statin use was observed in 61 (25.3%) patients. Statin use was independently negatively associated with handgrip strength at discharge (β = −0.095, P = 0.032), but not with skeletal muscle mass index at discharge (β = 0.019, P = 0.692).ConclusionsStatin use was negatively associated with muscle strength recovery, but not with muscle mass in patients with sarcopenia who underwent rehabilitation after stroke. To maximize outcomes, sufficient consideration is needed for statin use in these patients. Geriatr Gerontol Int 2023; ••: ••–••.

Drug‐related sarcopenia as a secondary sarcopenia

“…Several observational studies have shown that statins reduce physical activity, 8 muscle strength, 9,10 and delay muscle recovery after cerebrovascular injury. 11 However, there are several conflicting reports that statins do not affect skeletal muscle mass 12 and that statins reduce the development of sarcopenia and enhance physical function. [13][14][15] In the only intervention study targeting the effects of statins on skeletal muscle (420 healthy subjects followed for 6 months for exercise capacity and muscle strength after 80 mg atorvastatin or placebo), during the observation period, 9.4% in the statin group (4.6% in the placebo group, P = 0.05) developed myalgia and a mild elevation of serum CK was observed in the statin group (mean increase since enrollment 20.8 AE 141.1 U/L).…”

“…Several observational studies have shown that statins reduce physical activity, 8 muscle strength, 9,10 and delay muscle recovery after cerebrovascular injury 11 . However, there are several conflicting reports that statins do not affect skeletal muscle mass 12 and that statins reduce the development of sarcopenia and enhance physical function 13–15 .…”

Association of lipid-lowering drugs with risk of sarcopenia: a drug target mendelian randomization study and meta-analysis

“…Sarcopenia is a progressive and generalized skeletal muscle disorder characterized by accelerated loss of muscle strength, mass and function, leading to an increased risk of falls and hospitalization, particularly among the elderly population. A previous retrospective cohort study involving 586 sarcopenia patients reported an adverse association between statin use and recovery of muscle strength [ 9 ]. However, there exists inconsistency in the current clinical evidence, as another cross-sectional study including 136 heart failure patients found that statin use was associated with a reduced likelihood of developing sarcopenia [ 10 ].…”