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Statin-associated myopathy with normal creatine kinase levels.


http://www.ncbi.nlm.nih.gov/pubmed/12353945 

Abstract

BACKGROUND: Muscle symptoms in patients who are treated with statins and have normal creatine kinase levels are not well understood.

OBJECTIVE: To report biopsy-confirmed myopathy and normal creatine kinase levels associated with statin use.

DESIGN: Case reports from preliminary analysis of an ongoing clinical trial.

SETTING: Clinical research center in a community hospital.

PATIENTS: Four patients with muscle symptoms that developed during statin therapy and reversed during placebo use.

MEASUREMENTS: 1) Patients' ability to identify blinded statin therapy and 2) standard measures of functional capacity and muscle strength.

RESULTS: All four patients repeatedly distinguished blinded statin therapy from placebo. Strength testing confirmed weakness during statin therapy that reversed during placebo use. Muscle biopsies showed evidence of mitochondrial dysfunction, including abnormally increased lipid stores, fibers that did not stain for cytochrome oxidase activity, and ragged red fibers. These findings reversed in the three patients who had repeated biopsy when they were not receiving statins. Creatine kinase levels were normal in all four patients despite the presence of significant myopathy.

CONCLUSION: Some patients who develop muscle symptoms while receiving statin therapy have demonstrable weakness and histopathologic findings of myopathy despite normal serum creatine kinase levels.

PMID: 12353945 [PubMed - indexed for MEDLINE]Free Article

NIH DHHS USA.gov


* Summaries for patients. Muscle abnormalities in four patients taking statins to treat unfavorable cholesterol levels. [Ann Intern Med. 2002]
Summaries for patients. Muscle abnormalities in four patients taking statins to treat unfavorable cholesterol levels.
. Ann Intern Med. 2002 Oct 1; 137(7):I45.
* Muscle symptoms associated with statins: a series of twenty patients. [Basic Clin Pharmacol Toxicol. 2006]
Muscle symptoms associated with statins: a series of twenty patients.
Soininen K, Niemi M, Kilkki E, Strandberg T, Kivistö KT. Basic Clin Pharmacol Toxicol. 2006 Jan; 98(1):51-4.
* Statin-associated myopathy with normal creatine kinase levels. Case report from a Norwegian family. [APMIS. 2005]
Statin-associated myopathy with normal creatine kinase levels. Case report from a Norwegian family.
Trřseid M, Henriksen OA, Lindal S. APMIS. 2005 Sep; 113(9):635-7.
* Review Statin-associated myopathy. [Med J Aust. 2001]
Review Statin-associated myopathy.
Hamilton-Craig I. Med J Aust. 2001 Nov 5; 175(9):486-9.
* Review Statin-associated myopathy. [JAMA. 2003]
Review Statin-associated myopathy.
Thompson PD, Clarkson P, Karas RH. JAMA. 2003 Apr 2; 289(13):1681-90.

Cited by 14 PubMed Central articles

* Association between statin-associated myopathy and skeletal muscle damage. [CMAJ. 2009]
Association between statin-associated myopathy and skeletal muscle damage.
Mohaupt MG, Karas RH, Babiychuk EB, Sanchez-Freire V, Monastyrskaya K, Iyer L, Hoppeler H, Breil F, Draeger A. CMAJ. 2009 Jul 7; 181(1-2):E11-8.
* High-dose statin use does not impair aerobic capacity or skeletal muscle function in older adults. [Age (Dordr). 2008]
High-dose statin use does not impair aerobic capacity or skeletal muscle function in older adults.
Traustadóttir T, Stock AA, Harman SM. Age (Dordr). 2008 Dec; 30(4):283-91. Epub 2008 Aug 21.
* Statin-induced muscle damage and atrogin-1 induction is the result of a geranylgeranylation defect. [FASEB J. 2009]
Statin-induced muscle damage and atrogin-1 induction is the result of a geranylgeranylation defect.
Cao P, Hanai J, Tanksale P, Imamura S, Sukhatme VP, Lecker SH. FASEB J. 2009 Sep; 23(9):2844-54. Epub 2009 Apr 30.

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