Abstract
Statins are an essential part of the management of patients at high vascular risk and are generally well-tolerated. However, statin intolerance will be observed more frequently as more stringent low density lipoprotein cholesterol (LDL-C) targets are pursued in an ever increasing number of patients. We review the management options for high-risk patients intolerant to statin treatment. Potential strategies include switching to a different statin, reducing the frequency of statin administration, substituting statins with other LDL-C-lowering agents (e.g. ezetimibe, colesevelam or nicotinic acid) and combining low-dose statin treatment with other lipid-modifying drugs. A limited number of studies specifically assessed statin-intolerant patients and most were small and of short duration. It is therefore difficult to make evidence-based recommendations for the management of this population. In addition, all treatment options have limitations in terms of safety and/or efficacy.
Keywords: Statins, myalgia, creatine kinase, transaminase, ezetimibe, nicotinic acid, colesevelam, fibrates, combination treatment
Current Vascular Pharmacology
Title: Management of Statin-Intolerant High-Risk Patients
Volume: 8 Issue: 5
Author(s): Konstantinos Tziomalos, Vasilios G. Athyros, Asterios Karagiannis and Dimitri P. Mikhailidis
Affiliation:
Keywords: Statins, myalgia, creatine kinase, transaminase, ezetimibe, nicotinic acid, colesevelam, fibrates, combination treatment
Abstract: Statins are an essential part of the management of patients at high vascular risk and are generally well-tolerated. However, statin intolerance will be observed more frequently as more stringent low density lipoprotein cholesterol (LDL-C) targets are pursued in an ever increasing number of patients. We review the management options for high-risk patients intolerant to statin treatment. Potential strategies include switching to a different statin, reducing the frequency of statin administration, substituting statins with other LDL-C-lowering agents (e.g. ezetimibe, colesevelam or nicotinic acid) and combining low-dose statin treatment with other lipid-modifying drugs. A limited number of studies specifically assessed statin-intolerant patients and most were small and of short duration. It is therefore difficult to make evidence-based recommendations for the management of this population. In addition, all treatment options have limitations in terms of safety and/or efficacy.
Export Options
About this article
Cite this article as:
Tziomalos Konstantinos, G. Athyros Vasilios, Karagiannis Asterios and P. Mikhailidis Dimitri, Management of Statin-Intolerant High-Risk Patients, Current Vascular Pharmacology 2010; 8 (5) . https://dx.doi.org/10.2174/157016110792006932
DOI https://dx.doi.org/10.2174/157016110792006932 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
The Emerging Role of Arginase in Endothelial Dysfunction in Diabetes
Current Vascular Pharmacology Effects of Endothelins on Cardiac and Vascular Cells: New Therapeutic Target for the Future?
Current Vascular Pharmacology Novel Inflammatory Biomarkers in Coronary Artery Disease: Potential Therapeutic Approaches
Current Medicinal Chemistry A Case-Control Study Investigating the Effect of MTHFR C677T Variant on Performance of Elite Athletes
Endocrine, Metabolic & Immune Disorders - Drug Targets The Proteomic Approach in the Development of Prognostic Biomarkers in Atherothrombosis
Recent Patents on Cardiovascular Drug Discovery Editorial
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery (Discontinued) Therapeutic Angiogenesis in Ischemic Tissues by Growth Factors and Bone Marrow Mononuclear Cells Administration: Biological Foundation and Clinical Prospects
Current Stem Cell Research & Therapy Diabetes and Vascular Disease: Basic Concepts of Nitric Oxide Physiology, Endothelial Dysfunction, Oxidative Stress and Therapeutic Possibilities
Current Vascular Pharmacology Theoretical Possibilities for the Development of Novel Antiarrhythmic Drugs
Current Medicinal Chemistry An Insight of Novel Pharmacological Therapies in Hypertrophic Cardiomyopathy
Medicinal Chemistry Incretins and Preservation of Endothelial Function
Cardiovascular & Hematological Agents in Medicinal Chemistry Antiplatelet Therapy in the Prevention of Coronary Syndromes: Mode of Action, Benefits, Drawbacks
Cardiovascular & Hematological Agents in Medicinal Chemistry Fungal Bioactive Compounds in Pharmaceutical Research and Development
Current Bioactive Compounds Targeting IL-17 and IL-23 in Immune Mediated Renal Disease
Current Medicinal Chemistry Mental Health Patients at High Risk for Obesity, Type 2 Diabetes, and Cardiovascular Disease: An Australian Perspective
Current Hypertension Reviews Epidemiology and Costs of Hypertension-related Disorders
Current Pharmaceutical Design Progress in the Development of Aminopeptidase N (APN/CD13) Inhibitors
Current Medicinal Chemistry - Anti-Cancer Agents Alkaloids as Important Scaffolds in Therapeutic Drugs for the Treatments of Cancer, Tuberculosis, and Smoking Cessation
Current Topics in Medicinal Chemistry Fast Food Versus Slow Food and Hypertension Control
Current Hypertension Reviews The Metabolic Syndrome and Vascular Disease in Asia
Cardiovascular & Hematological Disorders-Drug Targets