[Severe rhabdomyolysis associated with atorvastatin. Case report].

Jorge Medina-Romero, Otoniel Toledo-Salinas, Francisco Javier Reyes-Álvarez, Saira Sanjuana Gómez-Flores
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Abstract

Background: Dyslipidemia is a risk factor for the development of atherosclerosis and ischemic heart disease. Statins are safe drugs that are part of the routine treatment in patients with Acute Myocardial Infarction (AMI), however, rhabdomyolysis associated with severe myonecrosis due to statins can occur and associated complications such as acute kidney injury increase mortality. The main objective of this article is to report the case of a critically ill patient with AMI who presented severe statin-associated rhabdomyolysis documented with muscle biopsy.

Description of the case: A 54-year-old man who presented with AMI, cardiogenic shock, and cardiorespiratory arrest requiring cardiopulmonary resuscitation, fibrinolysis, and successful salvage coronary angiography. However, he presented severe rhabdomyolysis associated with atorvastatin that required suspension of the drug and multi-organ support in a Coronary Care Unit.

Conclusions: The prevalence of statin-associated rhabdomyolysis is low, however, the late elevation of CPK above 10 times its upper normal value in those patients with successful percutaneous coronary angiography should promptly draw attention, generate a diagnostic approach towards non-traumatic acquired causes of rhabdomyolysis and assess the suspension of statins.

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严重横纹肌溶解与阿托伐他汀相关。病例报告)。
背景:血脂异常是动脉粥样硬化和缺血性心脏病发生的危险因素。他汀类药物是安全的药物,是急性心肌梗死(AMI)患者常规治疗的一部分,然而,他汀类药物可导致横纹肌溶解和严重肌坏死,相关并发症如急性肾损伤增加死亡率。本文的主要目的是报告一例重症AMI患者,他汀类药物相关的横纹肌溶解经肌肉活检证实。病例描述:一名54岁男性,表现为急性心肌梗塞、心源性休克和心肺骤停,需要心肺复苏、纤维蛋白溶解和成功的抢救性冠状动脉造影。然而,他出现了与阿托伐他汀相关的严重横纹肌溶解,需要停药并在冠状动脉监护病房接受多器官支持。结论:他汀类药物相关横纹肌溶解的患病率较低,然而,在经皮冠状动脉造影成功的患者中,CPK晚期升高超过正常值上限的10倍应及时引起注意,对非创伤性获得性横纹肌溶解的诊断方法和评估他汀类药物的悬停。
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