Risk factors for statin-associated rhabdomyolysis
Risk factors for statin-associated rhabdomyolysis
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DOI：
10.1002/pds.1287
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发表时间：
2007-03-01
影响因子：
2.6
通讯作者：
Shatin, Deborah
中科院分区：
文献类型：
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作者：
Schech, Stephanie;Graham, David;Shatin, Deborah
目的识别和描述接受他汀类药物单药治疗或他汀类药物加贝特类药物治疗的患者中横纹肌溶解的风险因素。方法在地理位置分散的美国健康计划中，对252460名新使用降脂药物的队列进行了一项巢式病例对照研究。将21例经病历审查证实的横纹肌溶解症病例与200例无横纹肌溶解症的个体匹配对照进行比较。应用条件Logistic回归模型评估年龄、性别、合并症、合并用药、剂量和他汀类药物使用持续时间对横纹肌溶解症发生的影响。结果65岁及以上的他汀类药物使用者因横纹肌溶解症住院的风险是65岁以下者的4倍（OR = 4.36，95%可信区间CI：1.5，14，1）。我们还观察到高他汀类药物剂量和肾脏疾病的联合作用（p = 0.022）。当这两个变量随年龄加入模型时，我们获得的剂量OR为5.73（95%CI：0.63，52.6），肾脏疾病OR为6.26（95%CI：0.46，63.38）。虽然没有统计学意义，但我们确实观察到女性横纹肌溶解症的风险增加了两倍以上（OR= 2.53，95%CI：0.91，7.32）。结论本研究的结果表明，年龄较大是他汀类药物使用者横纹肌溶解症的危险因素。虽然证据不是那么有力，但高剂量他汀类药物、肾脏疾病和女性可能是额外的风险因素。发生横纹肌溶解症风险较高的患者应密切监测疾病的体征和症状。版权所有（c）2006约翰威利父子有限公司。
Purpose To identify and characterize risk factors for rhabdomyolysis in patients prescribed statin monotherapy or statin plus fibrate therapy.Methods A nested case-control study was conducted within a cohort of 252460 new users of lipid-lowering medications across I I geographically dispersed U.S. health plans. Twenty-one cases of rhabdomyolysis confirmed by medical record review were compared to 200 individually matched controls without rhabdomyolysis. A conditional logistic regression model was applied to evaluate the effects of age, gender, comorbidities, concurrent medication use, dosage, and duration of statin use on the development of rhabdomyolysis.Results Statin users 65 years of age and older have four times the risk of hospitalization for rhabdomyolysis than those under age 65 (odds ratio (OR) = 4.36, 95% confidence interval (Cl): 1.5,14, 1). We also observed a joint effect of high statin dosage and renal disease (p = 0.022). When these two variables were added to the model with age, we obtained an OR of 5.73 for dosage (95%CI: 0.63, 52.6) and 6.26 for renal disease (95%CI: 0.46, 63.38). Although not statistically significant, we did observe a greater than twofold increase in risk for rhabdomyolysis among females (OR= 2.53, 95%CI: 0.91, 7.32).Conclusions Findings of this study indicate that older age is a risk factor for rhabdomyolysis among statin users. Although the evidence is not as strong, high statin dosage, renal disease, and female gender may be additional risk factors. Patients at higher risk of developing rhabdomyolysis should be closely monitored for signs and symptoms of the disease. Copyright (c) 2006 John Wiley & Sons, Ltd.