Prevalence of statin intolerance: a meta-analysis
Bytyçi I, Penson PE, Mikhailidis DP, Wong ND, Hernandez AV, Sahebkar A, Thompson PD, Mazidi M, Rysz J, Pella D, Reiner Ž, Toth PP, Banach M
European heart journal · 360 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
Según la declaración de financiación del texto completo.
Publicación
- Publicado
- 2022-01-11 · Eur Heart J · vol. 43 · número 34 · págs. 3213–3223
- Editorial
- Oxford University Press
- Citado
- 472 citas · más que el 100% de estudios similares · 29.1× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 214 trabajos
- Acceso
- Acceso abierto (revista híbrida) · CC-BY
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Cancer, Lipids, and Metabolism · Pharmacovigilance and Adverse Drug Reactions
- Palabras clave
- statin intolerance, prevalence, statin adverse effects, diagnostic criteria, risk factors, primary and secondary prevention, obesity, diabetes mellitus, age and sex differences, cardiovascular risk, lipid-lowering therapy, statin-induced myopathy, rhabdomyolysis, hyperglycemia, hypokalemia, hypomagnesemia
- MeSH
- humans, lipids, hydroxymethylglutaryl-coa reductase inhibitors, prevalence, risk factors, female, male, atherosclerosis, randomized controlled trials as topic
13 autores
- Ibadete Bytyçi🇽🇰🇸🇪University Clinical Center of Kosovo; Umeå University
- Peter Edward Penson🇬🇧Liverpool John Moores University
- Dimitri P. Mikhailidis🇬🇧The Royal Free Hospital; University College London
- Nathan D. Wong🇺🇸University of California, Irvine
- Adrián Vladimir Hernández🇺🇸🇵🇪University of Connecticut; Universidad San Ignacio de Loyola
- Amirhossein Sahebkar🇮🇷Mashhad University of Medical Sciences
- Paul Daniel Thompson🇺🇸Hartford Hospital; University of Connecticut; UConn Health
- Mohsen Mazidi🇬🇧King's College London
- Jacek Rysz🇵🇱Medical University of Lodz
- Daniel Pella🇸🇰University of Pavol Jozef Šafárik; Východoslovenský ústav srdcových a cievnych chorôb, a.s.
- Željko Reiner🇭🇷University Hospital Centre Zagreb; University of Zagreb
- Peter Paul Toth🇺🇸Johns Hopkins University; Johns Hopkins Medicine; CGH Medical Center
- Maciej Banach🇵🇱 · autor de correspondenciaMedical University of Lodz; University of Zielona Góra
Resumen
El texto original del estudio, en el idioma en que se publicó.
Aims
Statin intolerance (SI) represents a significant public health problem for which precise estimates of prevalence are needed. Statin intolerance remains an important clinical challenge, and it is associated with an increased risk of cardiovascular events. This meta-analysis estimates the overall prevalence of SI, the prevalence according to different diagnostic criteria and in different disease settings, and identifies possible risk factors/conditions that might increase the risk of SI.
Methods and results
We searched several databases up to 31 May 2021, for studies that reported the prevalence of SI. The primary endpoint was overall prevalence and prevalence according to a range of diagnostic criteria [National Lipid Association (NLA), International Lipid Expert Panel (ILEP), and European Atherosclerosis Society (EAS)] and in different disease settings. The secondary endpoint was to identify possible risk factors for SI. A random-effects model was applied to estimate the overall pooled prevalence. A total of 176 studies [112 randomized controlled trials (RCTs); 64 cohort studies] with 4 143 517 patients were ultimately included in the analysis. The overall prevalence of SI was 9.1% (95% confidence interval 8.0-10%). The prevalence was similar when defined using NLA, ILEP, and EAS criteria [7.0% (6.0-8.0%), 6.7% (5.0-8.0%), 5.9% (4.0-7.0%), respectively]. The prevalence of SI in RCTs was significantly lower compared with cohort studies [4.9% (4.0-6.0%) vs. 17% (14-19%)]. The prevalence of SI in studies including both primary and secondary prevention patients was much higher than when primary or secondary prevention patients were analysed separately [18% (14-21%), 8.2% (6.0-10%), 9.1% (6.0-11%), respectively]. Statin lipid solubility did not affect the prevalence of SI [4.0% (2.0-5.0%) vs. 5.0% (4.0-6.0%)]. Age [odds ratio (OR) 1.33, P = 0.04], female gender (OR 1.47, P = 0.007), Asian and Black race (P < 0.05 for both), obesity (OR 1.30, P = 0.02), diabetes mellitus (OR 1.26, P = 0.02), hypothyroidism (OR 1.37, P = 0.01), chronic liver, and renal failure (P < 0.05 for both) were significantly associated with SI in the meta-regression model. Antiarrhythmic agents, calcium channel blockers, alcohol use, and increased statin dose were also associated with a higher risk of SI.
Conclusion
Based on the present analysis of >4 million patients, the prevalence of SI is low when diagnosed according to international definitions. These results support the concept that the prevalence of complete SI might often be overestimated and highlight the need for the careful assessment of patients with potential symptoms related to SI.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).
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