Statin therapy in athletes and patients performing regular intense exercise - Position paper from the International Lipid Expert Panel (ILEP)

Niki Katsiki; Dimitri P Mikhailidis; Gani Bajraktari; Andre R Miserez; Arrigo F G Cicero; Eric Bruckert; Maria-Corina Serban; Erkin Mirrakhimov; Fahad Alnouri; Željko Reiner; György Paragh; Amirhossein Sahebkar; Maciej Banach; International Lipid Expert Panel (ILEP)

doi:10.1016/j.phrs.2020.104719

Statin therapy in athletes and patients performing regular intense exercise - Position paper from the International Lipid Expert Panel (ILEP)

Pharmacol Res. 2020 May:155:104719. doi: 10.1016/j.phrs.2020.104719. Epub 2020 Feb 19.

Collaborators

International Lipid Expert Panel (ILEP):
Fahad Alnouri, Fahma Amar, Atanas G Atanasov, Gani Bajraktari, Maciej Banach, Marcin A Bartlomiejczyk, Bojko Bjelakovic, Eric Bruckert, Agata Bielecka-Dabrowa, Alberto Cafferata, Richard Ceska, Arrigo F G Cicero, Xavier Collet, Olivier Descamps, Nair Devaki, Dragan Djuric, Ronen Durst, Marat V Ezhov, Zlatko Fras, Dan Gaita, Stephan von Haehling, Adrian V Hernandez, Steven R Jones, Jacek Jozwiak, Nona Kakauridze, Niki Katsiki, Amit Khera, Karam Kostner, Raimondas Kubilius, Gustavs Latkovskis, G B John Mancini, A David Marais, Seth S Martin, Julio Acosta Martinez, Mohsen Mazidi, Dimitri P Mikhailidis, Erkin Mirrakhimov, Andre R Miserez, Olena Mitchenko, Patrick Moriarty, Seyed Mohammad Nabavi, Demosthenes B Panagiotakos, György Paragh, Daniel Pella, Peter E Penson, Zaneta Petrulioniene, Matteo Pirro, Arman Postadzhiyan, Raman Puri, Ashraf Reda, Željko Reiner, Jemaa Riadh, Dimitri Richter, Manfredi Rizzo, Massimiliano Ruscica, Amirhossein Sahebkar, Naveed Sattar, Maria-Corina Serban, Abdulla M A Shehab, Aleksandr B Shek, Cesare R Sirtori, Claudia Stefanutti, Tomasz Tomasik, Peter P Toth, Margus Viigimaa, Dragos Vinereanu, Branislav Vohnout, Michal Vrablik, Nathan D Wong, Hung-I Yeh, Jiang Zhisheng, Andreas Zirlik

Affiliations

¹ First Department of Internal Medicine, Division of Endocrinology and Metabolism, Diabetes Center, Medical School, AHEPA University Hospital, Thessaloniki, Greece. Electronic address: nikikatsiki@hotmail.com.
² Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK.
³ Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo, Serbia; Medical Faculty, University of Prishtina, Prishtina, Kosovo, Serbia; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
⁴ Diagene Research Institute, Reinach, Switzerland; University of Basel, Basel, Switzerland.
⁵ Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.
⁶ Pitié-Salpêtrière Hospital and Sorbonne University, Cardio Metabolic Institute, Paris, France.
⁷ Department of Functional Sciences, Discipline of Pathophysiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
⁸ Kyrgyz State Medical Academy, Named after Akhunbaev I.K., Bishkek, Kyrgyzstan.
⁹ Cardiovascular Prevention Unit, Adult Cardiology Department, Prince Sultan Cardiac Centre Riyadh, Saudi Arabia.
¹⁰ Department of Internal Diseases University Hospital Center Zagreb School of Medicine, Zagreb University, Zagreb, Croatia.
¹¹ Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
¹² Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
¹³ Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland. Electronic address: maciejbanach77@gmail.com.

PMID: 32087236
DOI: 10.1016/j.phrs.2020.104719

Abstract

Acute and chronic physical exercises may enhance the development of statin-related myopathy. In this context, the recent (2019) guidelines of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS) for the management of dyslipidemias recommend that, although individuals with dyslipidemia should be advised to engage in regular moderate physical exercise (for at least 30 min daily), physicians should be alerted with regard to myopathy and creatine kinase (CK) elevation in statin-treated sport athletes. However it is worth emphasizing that abovementioned guidelines, previous and recent ESC/EAS consensus papers on adverse effects of statin therapy as well as other previous attempts on this issue, including the ones from the International Lipid Expert Panel (ILEP), give only general recommendations on how to manage patients requiring statin therapy on regular exercises. Therefore, these guidelines in the form of the Position Paper are the first such an attempt to summary existing, often scarce knowledge, and to present this important issue in the form of step-by-step practical recommendations. It is critically important as we might observe more and more individuals on regular exercises/athletes requiring statin therapy due to their cardiovascular risk.

Keywords: Athleths; Exercises; Management; Mylagia; Statin intolerance.

Publication types

Review

MeSH terms

Athletes*
Consensus
Dyslipidemias / drug therapy
Exercise*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Muscular Diseases / chemically induced

Substances

Hydroxymethylglutaryl-CoA Reductase Inhibitors