Most patients on statins do not have a raised CK. I had thought that this
was an idiosyncratic, rather than a dose-related, effect.
If compliance is not an issue, I am sure that he will have been screened
for hypothyroidism. Some patients respond poorly to statins - I have
wondered whether this is related to their intestinal cholesterol absorption
- and it would certainly be worth his clinician prescribing him a bile acid
sequestrant.
William M
At 12:27 25/02/2002 +0000, GARETH DAVIES wrote:
>Dear All,
>
>We have been discussing a young (my age - upper 40s) patient with a
>cholesterol greater than 10mmol/l who is prescribed 80mg simvastatin but his
>cholesterol is not falling by the expected amount. We will be seeing him to
>ascertain whether he is compliant but a question that was raised concerns
>"resistance" to a statin formulation.
>
>At 80mg, we would expect a raised total CK. The question is: does the
>magnitude of a rasied CK correlate with the magnitude of the effect of the
>treatment on cholesterol levels? ie, is a higher CK associated with a
>diminished cholesterol-lowering effect
>
>I've had a look at PubMed but its difficult to phrase the search adequately.
>Has anyone come accross any published studies?
>
>Many thanks.
>
>Gareth
>
>Gareth Davies
>Senior Clinical Biochemist
>Wrexham Maelor Hospital
>Wrexham LL13 7TD
>UK
>01978 725345
>
>------ACB discussion List Information--------
>This is an open discussion list for the academic and clinical
>community working in clinical biochemistry.
>Please note, archived messages are public and can be viewed
>via the internet. Views expressed are those of the individual and
>they are responsible for all message content.
>
>ACB Web Site
>http://www.acb.org.uk
>List Archives
>http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
>List Instructions (How to leave etc.)
>http://www.jiscmail.ac.uk/
From: Dr William J Marshall
Reader and Hon Consultant in Clinical Biochemistry
GKT School of Medicine
London SE5 9PJ
UK
telephone: 020 7346 3275
facsimile: 020 7737 7434
email: [log in to unmask]
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|