{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T04:32:08Z","timestamp":1793853128940,"version":"4.6.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The South-Eastern Norway Regional Health Authority","award":["2019079"],"award-info":[{"award-number":["2019079"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To estimate the effect of atorvastatin on muscle symptom intensity in coronary heart disease (CHD) patients with self-perceived statin-associated muscle symptoms (SAMS) and to determine the relationship to blood levels of atorvastatin and\/or metabolites.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>A randomized multi-centre trial consecutively identified 982 patients with previous or ongoing atorvastatin treatment after a CHD event. Of these, 97 (9.9%) reported SAMS and 77 were randomized to 7-week double-blinded treatment with atorvastatin 40\u2009mg\/day and placebo in a crossover design. The primary outcome was the individual mean difference in muscle symptom intensity between the treatment periods, measured by visual-analogue scale (VAS) scores. Atorvastatin did not affect the intensity of muscle symptoms among 71 patients who completed the trial. Mean VAS difference (statin-placebo) was 0.31 (95% CI: \u22120.24 to 0.86). The proportion with more muscle symptoms during placebo than atorvastatin was 17% (n\u2009=\u200912), 55% (n\u2009=\u200939) had the same muscle symptom intensity during both treatment periods whereas 28% (n\u2009=\u200920) had more symptoms during atorvastatin than placebo (confirmed SAMS). There were no differences in clinical or pharmacogenetic characteristics between these groups. The levels of atorvastatin and\/or metabolites did not correlate to muscle symptom intensity among patients with confirmed SAMS (Spearman\u2019s rho \u22640.40, for all variables).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Re-challenge with high-intensity atorvastatin did not affect the intensity of muscle symptoms in CHD patients with self-perceived SAMS during previous atorvastatin therapy. There was no relationship between muscle symptoms and the systemic exposure to atorvastatin and\/or its metabolites. The findings encourage an informed discussion to elucidate other causes of muscle complaints and continued statin use.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvaa076","type":"journal-article","created":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T11:19:28Z","timestamp":1592997568000},"page":"507-516","source":"Crossref","is-referenced-by-count":25,"title":["Effect of atorvastatin on muscle symptoms in coronary heart disease patients with self-perceived statin muscle side effects: a randomized, double-blinded crossover trial"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4539-0239","authenticated-orcid":false,"given":"Oscar","family":"Kristiansen","sequence":"first","affiliation":[{"name":"Department of Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Dronninggata 28, Drammen 3004, Norway"},{"name":"Department of Behavioural Sciences in Medicine, Faculty of Medicine, University of Oslo, Domus Medica, Sognsvannsveien 9, Oslo 0372, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2649-4769","authenticated-orcid":false,"given":"Nils Tore","family":"Vethe","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Oslo University Hospital, Sognsvannsveien 20, Oslo 0372, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Peersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Vestfold Hospital Trust, Halfdan Wilhelmsens alle 17, T\u00f8nsberg 3103, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4535-5043","authenticated-orcid":false,"given":"Morten","family":"Wang Fagerland","sequence":"additional","affiliation":[{"name":"Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Domus Medica, Gaustad, Sognsvannsveien 9, Oslo 0372, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1519-9759","authenticated-orcid":false,"given":"Elise","family":"Sverre","sequence":"additional","affiliation":[{"name":"Department of Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Dronninggata 28, Drammen 3004, Norway"},{"name":"Department of Behavioural Sciences in Medicine, Faculty of Medicine, University of Oslo, Domus Medica, Sognsvannsveien 9, Oslo 0372, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Prun\u00e9s Jensen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Vestre Viken Hospital Trust, Dronninggata 28, Drammen 3004, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5568-7810","authenticated-orcid":false,"given":"Morten","family":"Lindberg","sequence":"additional","affiliation":[{"name":"Central Laboratory, Vestfold Hospital Trust, Halfdan Wilhelmsens alle 17, T\u00f8nsberg 3103, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6388-581X","authenticated-orcid":false,"given":"Erik","family":"Gjertsen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Dronninggata 28, Drammen 3004, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Gullestad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital Rikshospitalet, Sognsvannsveien 20, 0372, Oslo, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo, Sognsvannsveien 20, Oslo 0372, Norway"},{"name":"KG Jebsen Cardiac Research Centre, Oslo University Hospital, Postbox 4956 Nydalen, Oslo 0424, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joep","family":"Perk","sequence":"additional","affiliation":[{"name":"Department of 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