Amrita Krishnamurthy1, Corey Bradley2, Rebecca Ascunce1, Samuel M Kim3. 1. Department of Medicine, Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, 1305 York Avenue, 8th Floor, New York, NY, 10021, USA. 2. Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA. 3. Department of Medicine, Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, 1305 York Avenue, 8th Floor, New York, NY, 10021, USA. smk9018@med.cornell.edu.
Abstract
PURPOSE OF REVIEW: Statins are essential medications in the treatment of atherosclerotic cardiovascular disease; however, remain widely underutilized in large part due to concerns regarding adverse side effects. We describe the role of the nocebo effect in the perception of statin intolerance and provide management recommendations utilizing both statin and non-statin lipid-lowering therapies. RECENT FINDINGS: The recent Self-Assessment Method for Statin side-effects Or Nocebo (SAMSON) trial demonstrated that 90% of adverse symptoms related to statins were also elicited by placebo, a powerful demonstration of the nocebo effect. Importantly, 50% of the study patients were able to successfully reinitiate statin therapy. Statin intolerance is common and can often be managed with expectation setting and adjustment of doses and/or dosing regimens. In those who remain unable to tolerate statins, numerous alternative lipid-lowering therapies exist with strong safety and efficacy profiles.
PURPOSE OF REVIEW: Statins are essential medications in the treatment of atherosclerotic cardiovascular disease; however, remain widely underutilized in large part due to concerns regarding adverse side effects. We describe the role of the nocebo effect in the perception of statin intolerance and provide management recommendations utilizing both statin and non-statin lipid-lowering therapies. RECENT FINDINGS: The recent Self-Assessment Method for Statin side-effects Or Nocebo (SAMSON) trial demonstrated that 90% of adverse symptoms related to statins were also elicited by placebo, a powerful demonstration of the nocebo effect. Importantly, 50% of the study patients were able to successfully reinitiate statin therapy. Statin intolerance is common and can often be managed with expectation setting and adjustment of doses and/or dosing regimens. In those who remain unable to tolerate statins, numerous alternative lipid-lowering therapies exist with strong safety and efficacy profiles.
Authors: G G Schwartz; A G Olsson; M D Ezekowitz; P Ganz; M F Oliver; D Waters; A Zeiher; B R Chaitman; S Leslie; T Stern Journal: JAMA Date: 2001-04-04 Impact factor: 56.272
Authors: Connie W Tsao; Aaron W Aday; Zaid I Almarzooq; Alvaro Alonso; Andrea Z Beaton; Marcio S Bittencourt; Amelia K Boehme; Alfred E Buxton; April P Carson; Yvonne Commodore-Mensah; Mitchell S V Elkind; Kelly R Evenson; Chete Eze-Nliam; Jane F Ferguson; Giuliano Generoso; Jennifer E Ho; Rizwan Kalani; Sadiya S Khan; Brett M Kissela; Kristen L Knutson; Deborah A Levine; Tené T Lewis; Junxiu Liu; Matthew Shane Loop; Jun Ma; Michael E Mussolino; Sankar D Navaneethan; Amanda Marma Perak; Remy Poudel; Mary Rezk-Hanna; Gregory A Roth; Emily B Schroeder; Svati H Shah; Evan L Thacker; Lisa B VanWagner; Salim S Virani; Jenifer H Voecks; Nae-Yuh Wang; Kristine Yaffe; Seth S Martin Journal: Circulation Date: 2022-01-26 Impact factor: 39.918
Authors: Beth A Parker; Jeffrey A Capizzi; Adam S Grimaldi; Priscilla M Clarkson; Stephanie M Cole; Justin Keadle; Stuart Chipkin; Linda S Pescatello; Kathleen Simpson; C Michael White; Paul D Thompson Journal: Circulation Date: 2012-11-26 Impact factor: 29.690
Authors: Donna K Arnett; Roger S Blumenthal; Michelle A Albert; Andrew B Buroker; Zachary D Goldberger; Ellen J Hahn; Cheryl Dennison Himmelfarb; Amit Khera; Donald Lloyd-Jones; J William McEvoy; Erin D Michos; Michael D Miedema; Daniel Muñoz; Sidney C Smith; Salim S Virani; Kim A Williams; Joseph Yeboah; Boback Ziaeian Journal: Circulation Date: 2019-03-17 Impact factor: 29.690