Statin-Associated Myopathy in a Pediatric Preventive Cardiology Practice
| Autor: | Elizabeth Yellen, Nirav K. Desai, Justin P. Zachariah, Heather H. Ryan, Annette L. Baker, Sarah D. de Ferranti, Lucy Buckley, Suzanne Griggs, Philip K. Johnson, Dionne A. Graham, Shira Z. Warren, Michael M. Mendelson |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Statin Adolescent medicine.drug_class 030204 cardiovascular system & hematology Pediatrics 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Muscular Diseases 030225 pediatrics Internal medicine medicine Humans Adverse effect Myopathy Creatine Kinase biology business.industry Cholesterol Repeated measures design medicine.disease chemistry Pediatrics Perinatology and Child Health Multivariate Analysis Physical therapy biology.protein Creatine kinase Female medicine.symptom Hydroxymethylglutaryl-CoA Reductase Inhibitors business Rhabdomyolysis Body mass index Boston |
| Zdroj: | The Journal of pediatrics. 185 |
| ISSN: | 1097-6833 |
| Popis: | Objectives To describe muscle-related statin adverse effects in real-world pediatric practice. Study design Using prospectively collected quality improvement data from a pediatric preventive cardiology practice, we compared serum creatine kinase (CK) levels among patients prescribed and not prescribed statins, and pre-/poststatin initiation. Multivariable mixed-effect models were constructed accounting for repeated measures, examining the effect of statins on log-transformed CK (lnCK) levels adjusted for age, sex, weight, season, insurance type, and race/ethnicity. Results Among 1501 patients seen over 3.5 years, 474 patients (14 ± 4 years, 47% female) had at least 1 serum CK measured. Median (IQR) CK levels of patients prescribed (n = 188 patients, 768 CK measurements) and not prescribed statins (n = 351 patients, 682 CK measurements) were 107 (83) IU/L and 113 (81) IU/L, respectively. In multivariable-adjusted models, lnCK levels did not differ based on statin use (β = 0.02 [SE 0.05], P = .7). Among patients started on statins (n = 86, 130 prestatin and 292 poststatin CK measurements), median CK levels did not differ in adjusted models (β for statin use on lnCK = .08 [SE .07], P = .2). There was a clinically insignificant increase in CK over time (β = .08 [SE .04], P = .04 per year). No muscle symptoms or rhabdomyolysis were reported among patients with high CK levels. Conclusions In a real-world practice, pediatric patients using statins did not experience higher CK levels, nor was there a meaningful CK increase with statin initiation. These data suggest the limited utility to checking CK in the absence of symptoms, supporting current guidelines. |
| Databáze: | OpenAIRE |
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