Statin therapy
holds great promise for reducing the incidence of major
coronary events, coronary procedures, and stroke in high-risk patients. At
present, this potential has not been fully realized, because many patients
at heightened risk are not being treated with these drugs.
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There is a well
documented under-use of statins in clinical practice. Statins have proven
to be extremely safe in the vast majority of patients receiving them. Few
significant side effects were observed in clinical trials, and
post-marketing reports of adverse events have been very limited when
considered in comparison to the very large number of persons safely
receiving these drugs. Even so, these drugs are not entirely free of side
effects, and as for all drugs, they should be used appropriately and
judiciously. This advisory encourages the appropriate use of statins while
pointing out the possibility of side effects in certain patients.
If statins are used with appropriate caution in these selected patients, the
likelihood of developing clinically important myopathy should be
substantially reduced.
Statins are powerful low-density
lipoprotein (LDL)- lowering drugs that are widely used in clinical
practice. Results from clinical trials with a mean duration of 5.4 years
have demonstrated a decrease in CHD and total mortality, reductions in
myocardial infarctions, revascularization procedures, stroke, and
peripheral vascular disease (2– 8). These trials documented a benefit in
both men and women, primarily in middle-aged and older persons treated in
the setting of either primary or secondary prevention. More than 50,000
individuals have been randomized to either a placebo or statin in these
trials, and no serious morbidity or increase in mortality was
observed in the drug treatment groups. These agents reduce the risk of
essentially every clinical manifestation of the atherosclerotic process;
they are easy to administer, with good patient acceptance. There are very
few drug to drug interactions. Although the experience with the safety of
statin therapy outside of clinical trials has not been fully reported, it
is reasonable to suspect that the incidence of side effects may be higher
in clinical situations where patients are not monitored as closely as they
are in clinical trials.
Source: National Institute Of Health
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