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Medicina & Laboratorio

2010, Number 03-04

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Medicina & Laboratorio 2010; 16 (03-04)

Prevalencia de alteraciones de la creatina-fosfoquinasa (CPK) sérica en pacientes que toman estatinas

Toro EJM, Arango TCM, Campuzano MG, Villegas PA, Vélez HDA, Correa AEM

Language: Spanish
References: 43
Page: 141-152
PDF size: 389.91 Kb.


ABSTRACT

Introduction: The use of statins to treat dyslipidemia is associated with a spectrum of symptoms ranging from myalgia with or without increased creatine phosphokinase (CPK) to fatal rhabdomyolysis. Objective: To determine the prevalence of elevated CPK in patients taking statins and to identify possible risk factors associated with increased CPK in these patients. Methods: Cross-sectional observational study that assessed changes in CPK in a population of 503 patients treated with statins to control dyslipidemia, and attending the Hematology Clinical Laboratory in Medellin, Colombia for reasons other than the measurement of CPK. Using a questionnaire for patients, information on demographic data, personal history and type of statin used was obtained. Results: 56 (11,1%) patients had increased CPK above the normal reference range, 7 patients (1,4%) had increased levels two times above the upper normal value, of which 3 (0, 6%) had increased levels three times above the upper normal value. There was a significant association between high levels of CPK and male gender, and the use of selective serotonin reuptake inhibitors (SSRIs). No association was found with other risk factors previously described in other studies such as exercise, alcohol consumption, hypothyroidism and the dose of statins, among others. Regarding muscular symptoms, 28,4% reported muscle pain with statin use, 26% fatigue and 15,9% muscle weakness. Conclusion: The findings of this study demonstrate that an increase in CPK values in asymptomatic patients taking statins for cholesterol reduction, is greater than previously reported and confirmed that male gender and the use of SSRI are associated with increased CPK. We also found that the percentage of patients with muscle symptoms, especially pain and fatigue, is much higher than that reported in the literature. From the clinical point of view, the implications of having an asymptomatic increase in CPK are not known, this would require studies of long-term monitoring.


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