Abstract
The Canadian Consensus Working Group has updated its evaluation of the literature
pertaining to statin intolerance and adverse effects. This overview introduces a pragmatic
definition of statin intolerance (goal-inhibiting statin intolerance) that emphasizes
the effects of symptoms on achieving nationally vetted goals in patients fulfilling
indications for lipid-lowering therapy and cardiovascular risk reduction. The Canadian
Consensus Working Group provides a structured framework for avoiding, evaluating and
managing goal-inhibiting statin intolerance. Particularly difficult practice situations
are reviewed, including management in young and elderly individuals, and in athletes
and labourers. Finally, targeted at specialty practitioners, more detailed analyses
of specific but more unusual adverse effects ascribed to statins are updated including
evidence regarding new-onset diabetes, cognitive dysfunction, cataracts, and the rare
but important immune-mediated necrotizing myopathy.
Résumé
Le Canadian Consensus Working Group a mis à jour son évaluation de la littérature
concernant l’intolérance et les effets indésirables des statines. Cet aperçu présente
une définition pragmatique de l’intolérance aux statines (intolérance aux statines
GISI) qui souligne les effets des symptômes sur l’atteinte des objectifs approuvés
à l’échelon national chez les patients qui remplissent les indications de traitement
hypolipidémiant et de réduction du risque cardiovasculaire. Le Canadian Consensus
Working Group offre un cadre structuré pour éviter, évaluer et prendre en charge l’intolérance
aux statines GISI. Nous passons en revue des situations particulièrement difficiles
dans la pratique, dont la prise en charge des individus jeunes et âgés, des athlètes
et des ouvriers. Finalement, destinées aux praticiens spécialistes, des analyses plus
détaillées sur les effets secondaires particuliers, mais plus inhabituels attribués
aux statines sont mises à jour, y compris les données probantes concernant le diabète
de novo, le dysfonctionnement cognitif, les cataractes, et la rare, mais importante,
myopathie nécrosante immunomédiée.
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Article Info
Publication History
Published online: January 13, 2016
Accepted:
January 5,
2016
Received:
December 17,
2015
Footnotes
See page S56 for disclosure information.
Identification
Copyright
© 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
