Abstract
Background: Current evidence has established that statins are potent and effective agents with several pleiotropic effects in the treatment of coronary artery disease (CAD). Statins may have toxic effects, if given in higher doses and in combination.
Design: Literature review.
Methods: An Internet search and discussions with colleagues.
Results: The 1990s have been called the ‘statin decennial’ and the Nobel laureates suggested ‘CAD: eliminated with statins’. Statins were also proclaimed as wonder drugs, influencing a wide range of physiological, biochemical and biological functions. The list appears to be long and includes hypolipidaemic, vasodilative, antithrombotic, antioxidant, anti‐inflammatory, antiproliferative, anticoagulant, angiogenic and bone formation inducing functions. In January 2002, the television network CNN announced in a dispatch from London that deaths resulting from the treatment of hypercholesterolaemia with cerivastatin (Baycol) have now exceeded 100. Concerned Americans discussed this issue in May 2002, and published advice with the intention of summarizing for professionals current knowledge about statin use, focusing on myopathy. The criteria for the diagnosis of myopathy are not concerned with the symptoms of patients in the absence of raised muscle enzymes. Coenzyme Q10 is not considered in prophylaxis because one study showed no decrease in coenzyme Q10 in muscles in the presence of toxicity, although some studies indicated a reduction in serum levels.
Conclusion: Several studies have reported a significant reduction in serum coenzyme Q10 in patients taking statins. Such concern was also expressed by the International College of Cardiology at their meeting in April 2002; it was proposed that coenzyme Q10 should be considered in the prevention as well as the treatment of statin intoxication.