Author + information
- Received May 21, 2017
- Revision received July 20, 2017
- Accepted July 21, 2017
- Published online August 28, 2017.
- Robert S. Rosenson, MDa,∗ (, )
- Steven Baker, MSc, MDb,
- Maciej Banach, MD, PhDc,d,
- Kenneth M. Borow, MDe,
- Lynne T. Braun, PhD, CNPf,
- Eric Bruckert, MDg,
- Liam R. Brunham, MD, PhDh,
- Alberico L. Catapano, MD, PhDi,
- Marshall B. Elam, PhD, MDj,
- G.B. John Mancini, MDk,
- Patrick M. Moriarty, MDl,
- Pamela B. Morris, MDm,
- Paul Muntner, PhDn,
- Kausik K. Ray, MD, MPhilo,
- Erik S. Stroes, MDp,
- Beth A. Taylor, PhDq,r,
- Valerie H. Taylor, MD, PhDs,
- Gerald F. Watts, DSc, MD, PhDt and
- Paul D. Thompson, MDr
- aDepartment of Medicine, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York
- bDepartment of Medicine, Neuromuscular Disease Clinic, McMaster University, Hamilton, Ontario, Canada
- cDepartment of Hypertension, Medical University of Lodz, Lodz, Poland
- dCardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
- eNational Medication Safety, Outcomes and Adherence Program, MediMergent, Rockville, Maryland
- fDepartment of Adult Health and Gerentologic Nursing, College of Nursing, Rush University Medical Center, Chicago, Illinois
- gInstitute of Cardiometabolism and Nutrition (ICAN), Endocrinology Department, Hopital Pitié Salpetrière, Paris, France
- hDepartment of Medicine, University of Vancouver, British Columbia, Canada
- iDepartment of Pharmacological and Biomolecular Sciences, University of Milan, IRCCS Multimedica, Milan, Italy
- jDepartments of Pharmacology and Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee
- kDepartment of Medicine, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
- lDivision of Clinical Pharmacology, Division of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
- mDepartment of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina
- nDepartment of Epidemiology, University of Alabama Birmingham, Birmingham, Alabama
- oImperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
- pDepartment of Vascular Medicine, AMC, Amsterdam, the Netherlands
- qDepartment of Kinesiology, University of Connecticut, Storrs, Connecticut
- rDivision of Cardiology, Hartford Hospital, Hartford, Connecticut
- sDepartment of Psychiatry, University of Toronto, Women’s College Hospital, Toronto, Ontario, Canada
- tCardiometabolic Service, Department of Cardiology, Royal Perth Hospital; School of Medicine, University of Western Australia, Perth, Western Australia
- ↵∗Address for correspondence:
Dr. Robert S. Rosenson, Icahn School of Medicine at Mount Sinai, Cardiovascular Institute, One Gustave L. Levy Place, Box 1030, New York, New York 10029.
Statins are highly effective for preventing cardiovascular events by reducing low-density lipoprotein cholesterol (LDL-C). However, many patients taking statins report muscle-related symptoms that prevent the use of guideline recommended doses. Patients with reported intolerance to statins have a high risk of cardiovascular events. Clinical strategies that optimize cardiovascular risk reduction through LDL-C lowering need to be applied in patients experiencing intolerable side effects that they attribute to statins. In this paper, the authors review definitions of statin intolerance, propose algorithms to better define statin intolerance, and describe approaches to optimize cardiovascular risk reduction among individuals reporting statin-associated muscle symptoms.
Dr. Rosenson has served on advisory boards for Amgen, CVS Caremark, Easy Vitals, Eli Lilly, Regeneron, and Sanofi; has received research grants to his institution from Akcea, Amgen, AstraZeneca, Esperion, Medicines Company, and Regeneron; had received honoraria from Akcea and Kowa; and has received royalties from UpToDate. Dr. Banach has served on advisory boards for Abbott Vascular, Amgen, Daichii-Sankyo, Esperion, Eli Lilly, Merck Sharp & Dohme, Resverlogix, and Sanofi; has served on speakers bureaus for Abbott/Mylan, Abbott Vascular, Actavis, Akcea, Amgen, Biofarm, KRKA, MSD, Sanofi, and Valeant; and has received grants from Valeant and Sanofi. Dr. Borow is a consultant for Amarin and MediMergent; has received honoraria from Amarin; and is a stock shareholder in Amarin, Amgen, MediMergent, Merck, Pfizer, Regeneron, and Synergy. Dr. Braun receives royalties from UpToDate. Dr. Bruckert has served on advisory boards for AstraZeneca, AMGEN, Genfit, MSD, Sanofi and Regeneron, Unilever, Institut Benjamin Delessert, Danone, Aegerion, Chiesi, Rottapharm-MEDA, Eli Lilly, and Ionis Pharmaceuticals. Dr. Brunham has served on an advisory board for Sanofi; and has received research grants from Sanofi and Amgen. Dr. Catapano has received grants from Amgen, Merck Sharp & Dohme, Pfizer, Regeneron, and Sanofi; has been a consultant for Akcea, Amgen, AstraZeneca, Esperion, Ionis, Kowa, Meda, Merck Sharp & Dohme, Pfizer, Regeneron, Sanofi, and Takeda; has served on speakers bureaus for Amgen, AstraZeneca, Kowa, Menarini, Meda, Mylan, Regeneron, and Sanofi; and has relationships with SigmaTau, Eli Lilly, Recordati, Mediolanum, Merck, Aegerion, Genzyme, and Bayer. Dr. Elam has received research grants to his institution from Amgen, Kowa, and Pfizer. Dr. Mancini has served on advisory boards for Amgen, Sanofi, Boehringer Ingelheim, and Esperion; has received research grants to institution from Amgen and Merck; and has received honoraria from Amgen and Sanofi. Dr. Moriarty has served on advisory boards for Aegerion, Eli Lilly, Eliaz Therapeutics, Duke CRI, Esperion, Genzyme, and Ionis; has received research grants to his institution from Amgen, Arisaph, Catabasis, Ionis, Pfizer, Novartis, Regeneron, Sanofi, and Stage 2 Innovations; and has served on speakers bureaus for Amgen, Kowa, and Regeneron. Dr. Morris has served on advisory boards for Amgen, Sanofi Regeneron, and AstraZeneca; and has received research grants to her institution from Amgen. Dr. Muntner has received grants from Amgen. Dr. Ray has received grants from Pfizer, Amgen, Regeneron, Sanofi, and Merck Sharp and Dohme; has been a consultant for Akcea, Amgen, Regeneron, Sanofi, Pfizer, AstraZeneca, Boehringer Ingelheim, Takeda, Novo Nordisk, Merck Sharp and Dohme, Cerenis, Medicine Company, Kowa, Esperion; and has served on speakers bureaus for Amgen, Sanofi, Regeneron, Takeda, Boehringer Ingelheim, AstraZeneca, Cipla Alorithm, and Kowa. Dr. Stroes has served on advisory boards and speakers bureaus for Amgen, Sanofi, AstraZeneca, and Chiesi. Dr. B.A. Taylor has received research grants to her institution from Regeneron; and has served on an advisory board for Amgen. Dr. V.H. Taylor has received an investigator-initiated grant from Bristol-Myers Squibb; has served on advisory boards for Shire and NoroNordisk; and has received honoraria from Sunovion, Lundbeck, and Shire. Dr. Watts has served on advisory boards for Amgen, Regeneron, Sanofi, and Gemphire; and has received research grants to his institution from Amgen, Regeneron, and Sanofi; and has received honoraria from Amgen, Regeneron, Sanofi, Kowa, and Gemphire. Dr. Thompson has served on advisory boards for Regeneron, Sanofi, and Esperion; has received research support from Sanofi, Regeneron, Esperion, and Amarin; has received honoraria from Amarin, Regeneron, Sanofi, and Amgen; is a stock shareholder in Abbvie, Abbott Laboratories, Johnson & Johnson, General Electric, Serapta, and Medtronic; and has served as a malpractice consultant for statin myopathy and for cardiac complications of exercise. Dr. Baker has reported that he has no relationships relevant to the contents of this paper to disclose. P.K. Shah, MD, served as Guest Editor-in-Chief for this paper. Christie Mitchell Ballantyne, MD, served as Guest Editor for this paper.
- Received May 21, 2017.
- Revision received July 20, 2017.
- Accepted July 21, 2017.
- 2017 American College of Cardiology Foundation