False versus True Statin Intolerance in Patients with Peripheral Artery Disease.
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BORIS DOI
Publisher DOI
PubMed ID
36431097
Description
BACKGROUND
Statin intolerance (SI) is often documented in patients' charts but rarely confirmed by objective methods.
OBJECTIVE
We aimed to identify the rate of true SI in a large population with peripheral artery disease (PAD) as well as the subsequent use of such drugs and the impact on cardiovascular outcomes.
METHODS
Patients with PAD and reported SI were retrospectively classified in those with "probable/possible" (pp) and "unlikely" (u) SI, after the application of the "Statin Myalgia Clinical Index Score" (SAMS-CI). Both groups were compared after 62 months (date of observation period?).
RESULTS
Among the 4,505 included patients, 139 (3%) had been reported as having SI. Of those, 33 (24%) had ppSI, and 106 (76%) had uSI. During the observation period, statin use decreased in patients with both ppSI (from 97% to 21%; p < 0.0001) and uSI (from 87% to 53%; p < 0.0001). At the end of the observation period, patients with ppSI more often received PCSK9 inhibitors (55% vs. 7%; p < 0.0001), had a stronger decrease in LDL-C from baseline to follow-up (1.82 ± 1.69 mmol/L vs. 0.85 ± 1.41 mmol/L; p < 0.01), and a lower rate of mortality (3% vs. 21%; p = 0.04) than those with uSI.
CONCLUSIONS
SI is low in PAD patients (3.1%), with only one quarter fulfilling the criteria of ppSI. The overdiagnosis of SI is related to an underuse of statins and an increased mortality in a short time period.
Statin intolerance (SI) is often documented in patients' charts but rarely confirmed by objective methods.
OBJECTIVE
We aimed to identify the rate of true SI in a large population with peripheral artery disease (PAD) as well as the subsequent use of such drugs and the impact on cardiovascular outcomes.
METHODS
Patients with PAD and reported SI were retrospectively classified in those with "probable/possible" (pp) and "unlikely" (u) SI, after the application of the "Statin Myalgia Clinical Index Score" (SAMS-CI). Both groups were compared after 62 months (date of observation period?).
RESULTS
Among the 4,505 included patients, 139 (3%) had been reported as having SI. Of those, 33 (24%) had ppSI, and 106 (76%) had uSI. During the observation period, statin use decreased in patients with both ppSI (from 97% to 21%; p < 0.0001) and uSI (from 87% to 53%; p < 0.0001). At the end of the observation period, patients with ppSI more often received PCSK9 inhibitors (55% vs. 7%; p < 0.0001), had a stronger decrease in LDL-C from baseline to follow-up (1.82 ± 1.69 mmol/L vs. 0.85 ± 1.41 mmol/L; p < 0.01), and a lower rate of mortality (3% vs. 21%; p = 0.04) than those with uSI.
CONCLUSIONS
SI is low in PAD patients (3.1%), with only one quarter fulfilling the criteria of ppSI. The overdiagnosis of SI is related to an underuse of statins and an increased mortality in a short time period.
Date of Publication
2022-11-08
Publication Type
Article
Keyword(s)
lipid-lowering therapy low-density lipoprotein cholesterol mortality peripheral artery disease statin intolerance
Language(s)
en
Contributor(s)
Drexel, Heinz |
Additional Credits
Series
Journal of clinical medicine
Publisher
MDPI
ISSN
2077-0383
Access(Rights)
open.access