1/ Your 56-year-old patient with DM2, HTN, HLD, and a prior MI, comes to clinic reporting he stopped his statin a few weeks ago. “The muscle cramps were killing me, doc,” he tells you.
Let's take a deep dive into statin intolerance 💊🩺🫀
7/ This is a BIG problem, because it’s actually pretty common....
Take a guess at how common...?
8/
Well, different studies tell different stories, from 2-3% to 50%.
This 2022 @ehj_ed meta-analysis reported 9.1% of patients w/ adverse MSK effects that prevented them from using statins or limited guideline-recommended doses.
9/ Sidebar: whether the MSK side-effects of statins are “real” or psychosomatic is a fascinating question, but may be a moot point if patients are stopping their statin regardless.
Nonetheless, here’s one of my favorite studies of statins vs. placebo.
Yes! In fact, prior work in the @AmericanHeartJ suggests that up to 72% of patients can tolerate a statin when transitioned to intermittent dosing while still achieving great LDL ⬇️
1/ You see a 56 y.o man with a h/o HTN, DM2 & HLD in your clinic. He’s been out of care for a while and you’re concerned about his ASCVD risk. You order a lipid panel, but wonder, “should I also add an ApoB level?”