Heart Artery Disease

• Introduction
• Chest pain
  • Angina
  • Other chest pain
• Heart attack (myocardial infarction)
  • Introduction
• Assessment of the heart arteries
  • Treadmill stress test
  • Stress echocardiogram
  • Stress nuclear studies
  • Angiogram- invasive
  • Angiogram- CT
• Treatment of heart artery disease
  • Medication
  • Stent treatment
  • Heart bypass surgery

Muscle Aching with Statin Drugs

Coenzyme Q10 may not be very helpful

A class of medication, referred to as "statins" are widely prescribed to reduce cholesterol levels. These agents have been proven to reduce the risk of first heart attack and also reduce the risk of recurrent events after a first heart attack.

In New Zealand Simvastatin (Lipex) and Atorvastatin (Lipitor) are available.

On rare occasions the statin drugs cause severe inflammation of the muscles- this can seriously affect the function of the kidneys. Those taking the statin drugs should promptly report problems with aching muscles for further evaluation.

The statin drugs are often regarded as the cause of muscle aching even when there is no evidence of severe inflammation.

In the Heart Protection Study 6-7 percent of patients reported problems with aching muscles. However, at any time point, the proportion of patients with muscle aching was not higher in the group taking statin drugs compared to the group taking placebo (dummy) tablets. This observation does suggest that statin drugs rarely cause muscle aching.

Coenzyme Q10 supplements, available over-the-counter from pharmacies has been used to reduce muscle aches that occur with statin drugs.

A recent review found that there was a lack of high quality evidence favouring the use of coenzyme Q10 in this situation.

If coenzyme Q10 is trailed then a 200mg daily dose should be used.

Reference: Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-associated myopathy. J Am Coll Cardiol 2007; 49:2231-2237.