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This review finds that clinicians should assess symptoms carefully, rule out alternative causes, and consider dose reduction, statin switching, or intermittent dosing to maintain adherence to prevent cardiovascular events.<\/jats:p>","DOI":"10.61409\/v03250169","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T12:44:26Z","timestamp":1761137066000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["Statin-induced muscle symptoms"],"prefix":"10.61409","author":[{"given":"Peter","family":"Breining","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian S\u00f8rensen","family":"Bork","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars Erik","family":"Bartels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Asger","family":"Andersen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"40208","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"key":"ref0","unstructured":"Hjerteforeningen. 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Negative statin-related news stories decrease statin persistence and increase myocardial infarction and cardiovascular mortality: a nationwide prospective cohort study. Eur Heart J. 2016;37(11):908-916. https:\/\/doi.org\/10.1093\/eurheartj\/ehv641","DOI":"10.1093\/eurheartj\/ehv641"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Vinogradova Y, Coupland C, Brindle P, Hippisley-Cox J. Discontinuation and restarting in patients on statin treatment: prospective open cohort study using a primary care database. BMJ. 2016;353:i3305. https:\/\/doi.org\/10.1136\/bmj.i3305","DOI":"10.1136\/bmj.i3305"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Thompson W, Morin L, Jarb\u00f8l DE et al. Statin discontinuation and cardiovascular events among older people in Denmark. JAMA Netw Open. 2021;4(12):e2136802. https:\/\/doi.org\/10.1001\/jamanetworkopen.2021.36802","DOI":"10.1001\/jamanetworkopen.2021.36802"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Thompson PD, Taylor BA, red. Statin-associated muscle symptoms. 1st ed. Springer Humana Press, 2020","DOI":"10.1007\/978-3-030-33304-1_1"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Stroes ES, Thompson PD, Corsini A et al. Statin-associated muscle symptoms: impact on statin therapy-European Atherosclerosis Society consensus panel statement on assessment, aetiology and management. Eur Heart J. 2015;36(17):1012-22. https:\/\/doi.org\/10.1093\/eurheartj\/ehv043","DOI":"10.1093\/eurheartj\/ehv043"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Cholesterol Treatment Trialists' Collaboration. Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials. 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