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Medical Forum / General / Cardiology / July 2006

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TO: Sharon Hope...

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listener - 12 Jul 2006 13:20 GMT
You stated:

"A recently published medical journal article showed 100% of statin
patients have muscle damage identifiable on muscle biopsy after only a few
months.

Another recently published study showed all statin patients have measurable
cognitive impacts after 6 months.

Another recently published study showed neuropathy 26 times more likely in
statin patients."

Could you please supply links for these three statements?

Thank you.

L.
Matti Narkia - 12 Jul 2006 16:03 GMT
>"A recently published medical journal article showed 100% of statin
>patients have muscle damage identifiable on muscle biopsy after only a few
>months.

I'm not Sharon, but here's what I found. First, the muscle damage:

Draeger A, Monastyrskaya K, Mohaupt M, Hoppeler H, Savolainen H,
Allemann C, Babiychuk E.
Statin therapy induces ultrastructural damage in skeletal muscle in
patients without myalgia.
J Pathol. 2006 Jun 23; [Epub ahead of print]
PMID: 16799920 [PubMed - as supplied by publisher]
<http://www3.interscience.wiley.com/cgi-bin/fulltext/112659477/HTMLSTART>

   "Muscle pain and weakness are frequent complaints in patients
   receiving 3-hydroxymethylglutaryl coenzymeA (HMG CoA) reductase
   inhibitors (statins). Many patients with myalgia have creatine
   kinase levels that are either normal or only marginally
   elevated, and no obvious structural defects have been reported
   in patients with myalgia only. To investigate further the
   mechanism that mediates statin-induced skeletal muscle damage,
   skeletal muscle biopsies from statin-treated and non-statin-
   treated patients were examined using both electron microscopy
   and biochemical approaches. The present paper reports clear
   evidence of skeletal muscle damage in statin-treated patients,
   despite their being asymptomatic. Though the degree of overall
   damage is slight, it has a characteristic pattern that includes
   breakdown of the T-tubular system and subsarcolemmal rupture.
   These characteristic structural abnormalities observed in the
   statin-treated patients were reproduced by extraction of
   cholesterol from skeletal muscle fibres in vitro. These
   findings support the hypothesis that statin-induced cholesterol
   lowering per se contributes to myocyte damage and suggest
   further that it is the specific lipid/protein organization of
   the skeletal muscle cell itself that renders it particularly
   vulnerable.

   [...]

   ... We collected skeletal muscle samples from a total of 22
   individuals, including 14 who were receiving treatment with HMG
   CoA reductase inhibitors for hypercholesterolaemia and eight
   individuals who had not received statin treatment and served as
   controls. None of the patients had a previous history of
   rhabdomyalgia or weakness. ...

   [...]

   Skeletal muscle biopsies from a total of 14 patients treated with
   pravastatin (n = 2), atorvastatin (n = 4), or simvastatin (n = 8)
   and eight individuals without statin treatment underwent
   morphological evaluation, analysis of membrane-lipid contents as
   well as quantification of levels of mRNA abundance of six
   cholesterol-associated proteins (Table 1). None of our patients
   was treated with fibrates, which are known to potentiate myopathy
   in statin-treated patients, and one individual was prescribed
   ezetimibe (Table 1). Other relevant concomitant medications
   include Ca2+-channel blockers (n = 4), cyclosporin (n = 1),
   cephalosporin (n = 8), digoxin (n = 1), and warfarin (n = 7), all
   of which are known to interfere with statin metabolism [20].

   Morphological analysis demonstrated that the structural integrity
   of skeletal muscle fibres was compromised in 10 of 14 of the
   statin-treated patients and in only one of eight controls (Table
   1; p = 0.02)."

   There were no apparent differences in the degree of muscle injury
   observed in the statin-treated patients taking each specific
   statin, but these patient groups were quite small."

So the muscle damage seems to be very common even in cases, where
there are no symptoms. Still, it does dot seem to occur in all statin
users, but perhaps in majority of them: in this smalla study in 71% of
statin users.

>Another recently published study showed all statin patients have measurable
>cognitive impacts after 6 months.

The articles about the cognitive effects of statins are conflicting.
Both cognitive impairment and benefits have been reported. In any case
effects seem to be small. It may be possible that for different
populations and individuals the effects may be opposite. The effects
may also depend of the statin used. Here some of the articles:

Cognitive impairment:

Xiong GL, Benson A, Doraiswamy PM.
Statins and cognition: what can we learn from existing randomized
trials?
CNS Spectr. 2005 Nov;10(11):867-74. Review.
PMID: 16273014 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ct&list_uids=16273014
>

   "... Overall, none of these studies reported finding a positive
   benefit for any statin on cognition in non-demented subjects
   although there was inconsistent evidence for acute cognitive
   worsening in some studies. ..."

Muldoon MF, Ryan CM, Sereika SM, Flory JD, Manuck SB.
Randomized trial of the effects of simvastatin on cognitive
functioning in hypercholesterolemic adults.
Am J Med. 2004 Dec 1;117(11):823-9.
PMID: 15589485 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ct&list_uids=16273014
>

   "CONCLUSION: This study provides partial support for minor
   decrements in cognitive functioning with statins. Whether such
   effects have any long-term sequelae or occur with other
   cholesterol-lowering interventions is not known."

King DS, Wilburn AJ, Wofford MR, Harrell TK, Lindley BJ, Jones DW.
Cognitive impairment associated with atorvastatin and simvastatin.
Pharmacotherapy. 2003 Dec;23(12):1663-7.
PMID: 14695047 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ct&list_uids=1469504
>

   "Clinicians should be aware of cognitive impairment and dementia
   as potential adverse effects associated with statin therapy."

Wagstaff LR, Mitton MW, Arvik BM, Doraiswamy PM.
Statin-associated memory loss: analysis of 60 case reports and review
of the literature.
Pharmacotherapy. 2003 Jul;23(7):871-80. Review.
PMID: 12885101 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ct&list_uids=12885101
>

   "CONCLUSION: Current literature is conflicting with regard to
   the effects of statins on memory loss. Experimental studies
   support links between cholesterol intake and amyloid synthesis;
   observational studies indicate that patients receiving statins
   have a reduced risk of dementia. However, available prospective
   studies show no cognitive or antiamyloid benefits for any
   statin. In addition, case reports raise the possibility that
   statins, in rare cases, may be associated with cognitive
   impairment, though causality is not certain."

Orsi A, Sherman O, Woldeselassie Z.
Simvastatin-associated memory loss.
Pharmacotherapy. 2001 Jun;21(6):767-9.
PMID: 11401190 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ct&list_uids=11401190
>

   "The statins are widely used to treat dyslipidemias. They are
   generally associated with mild adverse effects, but rarely, more
   serious reactions may occur. A 51-year-old man experienced
   delayed-onset, progressive memory loss while receiving simvastatin
   for hypercholesterolemia. His therapy was switched to pravastatin,
   and memory loss resolved gradually over the next month, with no
   recurrence of the adverse effect."

Cognitive benefits:

Bernick C, Katz R, Smith NL, Rapp S, Bhadelia R, Carlson M, Kuller L;
Cardiovascular Health Study Collaborative Research Group. Statins and
cognitive function in the elderly: the Cardiovascular Health Study.
Neurology. 2005 Nov 8;65(9):1388-94.
PMID: 16275825 [PubMed - indexed for MEDLINE]
<http://www.neurology.org/cgi/content/abstract/65/9/1388>

   "Conclusion:  Statin drug use was associated with a slight
   reduction in cognitive decline in an elderly population. This
   relationship could not be completely explained by the effect of
   statins on lowering of serum cholesterol."

Parale GP, Baheti NN, Kulkarni PM, Panchal NV.
Effects of atorvastatin on higher functions.
Eur J Clin Pharmacol. 2006 Apr;62(4):259-65. Epub 2006 Feb 18.
PMID: 16489473 [PubMed - in process]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ct&list_uids=16489473
>

   "CONCLUSION: The present study concludes that there are
   significant beneficial effects of atorvastatin in a dose of 10
   mg/day for a period of 6 months on higher functions as measured by
   the above standard neurocognitive tests."

Etminan M, Gill S, Samii A.
The role of lipid-lowering drugs in cognitive function: a
meta-analysis of observational studies.
Pharmacotherapy. 2003 Jun;23(6):726-30.
PMID: 12820814 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ct&list_uids=12820814
>

   "CONCLUSION: Lipid-lowering drugs--in particular, the
   statins--seem to lower the odds of developing cognitive
   impairment. Randomized, controlled trials are needed to address
   the efficacy of these agents specifically in different types of
   dementia."

>Another recently published study showed neuropathy 26 times more likely in
>statin patients."

Neuropathy is a very rare side effect, but when it happens, it could
be crippling. I know about a person, who after starting statin therapy
lost the use of his legs so that he can no longer walk. Still,
according the following study statin use increases the risk of
neurpathy only by a factor of 1.3 and not 26-fold:

Corrao G, Zambon A, Bertu L, Botteri E, Leoni O, Contiero P.
Lipid lowering drugs prescription and the risk of peripheral
neuropathy: an exploratory case-control study using automated
databases.
J Epidemiol Community Health. 2004 Dec;58(12):1047-51.
PMID: 15547071 [PubMed - indexed for MEDLINE]
<http://jech.bmjjournals.com/cgi/content/full/58/12/1047>

   "This study estimates that users of lipid lowering drugs are at
   1.3-fold increased risk of developing peripheral neuropathy. "

Signature

Matti Narkia

William Wagner - 12 Jul 2006 16:49 GMT
> >"A recently published medical journal article showed 100% of statin
> >patients have muscle damage identifiable on muscle biopsy after only a few
[quoted text clipped - 210 lines]
>     "This study estimates that users of lipid lowering drugs are at
>     1.3-fold increased risk of developing peripheral neuropathy. "

I'm not Sharon either.

Bill an imbecile  on good days.

.................................

Nutrition. 2003 Nov-Dec;19(11-12):936-9.
Related Articles, Links

Effects of simvastatin administration in an experimental model of cancer
cachexia.

Muscaritoli M, Costelli P, Bossola M, Grieco G, Bonelli G, Bellantone R,
Doglietto GB, Rossi-Fanelli F, Baccino FM.

Department of Clinical Medicine, University La Sapienza, Rome, Italy.
maurizio.muscaritoli@uniroma1.it

OBJECTIVE: We evaluated whether statins, in view of their
anti-inflammatory properties, may effectively prevent the onset or
modulate the severity of muscle wasting during cancer cachexia. METHODS:
Simvastatin was administered to rats bearing the Yoshida AH-130 ascites
hepatoma, a well-studied cytokine-dependent experimental model of cancer
cachexia. RESULTS: Quite surprisingly, the drug negatively affected the
wasting pattern induced by the AH-130 hepatoma. In fact, the
administration of simvastatin to tumor hosts induced a further weight
reduction of all the tissues examined except for the soleus, in the
absence of significant effects of simvastatin on tumor growth or on food
intake. No effects were observed after simvastatin administration in
control animals, with the exception of a significant (P < 0.05)
reduction in heart weight. CONCLUSIONS: Simvastatin administration,
although capable of negatively modulating the inflammatory response, did
not prevent muscle wasting in this experimental model of cancer
cachexia. Moreover, the further muscle loss observed in
simvastatin-treated tumor-bearing animals suggests that a note of
caution should be introduced in treating cancer patients with statins in
view of the possible occurrence of harmful side effects.

PMID: 14624942 [PubMed - indexed for MEDLINE]

Signature

S Jersey USA Zone 5 Shade
This article is posted under fair use rules in accordance with
Title 17 U.S.C. Section 107, and is strictly for the educational
and informative purposes. This material is distributed without profit.

listener - 13 Jul 2006 16:20 GMT
William Wagner <not-to-here-williamwag@gmail.com> wrote in news:not-to-
here-williamwag-90B24F.11495112072006@sn-indi.vsrv-sjc.supernews.net:

> I'm not Sharon either.
>
[quoted text clipped - 35 lines]
>
> PMID: 14624942 [PubMed - indexed for MEDLINE]

Again, an interesting study and, obviously, you are not Sharon (LOL).
I'll ask again for Sharon to supply the links to these statements she
made:

"A recently published medical journal article showed 100% of statin
patients have muscle damage identifiable on muscle biopsy after only a
few months.

Another recently published study showed all statin patients have
measurable cognitive impacts after 6 months.

Another recently published study showed neuropathy 26 times more likely
in statin patients."

I would think she's seen this by now, even though she's killfiled me.
We've heard from David, from Matti and now from Bill. I'm honestly
interested in seeing the actual article and studies from which she based
her statements.

L.
 
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