title: Statin-associated rhabdomyolysis with acute renal failure complicated by intradialytic NSTEMI: a review of lipid management considerations.
abstract: Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are associated with myopathy, myalgias, myositis, and rhabdomyolysis. Rhabdoymyolysis is a rare complication and may cause acute renal failure, which may be fatal. In such cases, alternative therapies should be considered. In this review, we attempted to elucidate the lipid management options in patients with rhabdomyolysis and coronary artery disease. We also describe a case report of a patient who developed rhabdomyolysis from dual antilipid therapy followed by acute renal failure and non-ST elevation myocardial infarction. Such a complex case has not been reported in the literature, and lipid management options may include niacin, omega 3-fatty acids, or bile acid sequestrants. Once alternative therapies are initiated, monitoring a patient closely with evaluation for associated adverse events should be performed.
authors.affiliation: Department of Cardiology, Harry S Truman Memorial Veterans' Hospital, Columbia, MO, USA.
authors.forename: Subrata
authors.initials: S
authors.lastname: Kar
authors.forename: Anand
authors.initials: A
authors.lastname: Chockalingam
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D015248:Gemfibrozil / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology*; D006435:Renal Dialysis / Q000009:adverse effects*; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D019821:Simvastatin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D019821:Simvastatin; D015248:Gemfibrozil