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Medications
Published in Henry J. Woodford, Essential Geriatrics, 2022
One randomised trial of healthy young adults has assessed the impact of atorvastatin 80 mg od and placebo on muscle function (n = 420; mean age 44; six-month duration).66 It found a small average rise in serum CK (21 U/L) with atorvastatin and 10% of participants developed myalgia compared to 5% receiving placebo. The time to symptom onset averaged around 30 days. There was no obvious impact on muscle function. However, a study that compared a re-challenge with a statin to commencing a placebo in adults who had discontinued statins due to adverse effects found no significant association with muscle sysmptoms.67
Statins in acute coronary syndrome
Published in K Sarat Chandra, AJ Swamy, Acute Coronary Syndromes, 2020
ARMYDA ACS trial [8]: This was a randomised, prospective, double-blind, clinical trial to study the possible beneficial effect of high-dose atorvastatin in statin-naïve patients with ACS undergoing early PCI. 171 patients were randomised to placebo (n = 85) or atorvastatin (n = 86). 80 mg of atorvastatin was administered a mean of 12 hours before coronary angiography and a 40 mg dose approximately 2 hours before intervention. The primary composite end point of 30-day major adverse cardiac events (e.g. death, MI and target vessel revascularisation) was significantly reduced in the atorvastatin arm versus the placebo arm (5% vs. 17%. p = 0.01), and the outcome was mainly driven by periprocedural MI (5 vs. 15%; p = 0.04). On measuring CRP, it was seen that the average percentage increase of CRP levels from baseline was significantly lower in the statin arm. After multivariate analysis, pre-treatment with atorvastatin was associated with 88% and 70% relative risk reduction of 30-day events and periprocedural MI, respectively. The post-procedural elevation of CK-MB and Tn I above ULN was also significantly lower in the atorvastatin arm.
Lysinuric protein intolerance
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
Elevated levels of cholesterol and triglyceride were documented in 39 Finnish patients [17] whose fat intake was no higher than the general population. Successful lowering was obtained with statin therapy. The authors recommended atorvastatin over others because of more effective reduction of both cholesterol and triglyceride.
Atorvastatin treatment in a patient with post-traumatic hydrocephalus: a case report
Published in Brain Injury, 2022
Two years and four months after the injury, the patient showed spontaneous speech reduction without further functional declines. His head CT showed increased hydrocephalus, and further enlargement of ventricles, the span of the third ventricle was 24 mm, and Evan’s index rose to 0.63(Table 1). The neurosurgeon determined that it was not the time for a CSF shunt, because there were no further neurodegenerative symptoms. Under close observation, atorvastatin 20 mg orally once a day was added and we maintained the rest of the medication regimen. The patient received the same rehabilitation program as usual during the observation period. The increment rule of training strength remained unchanged (when the patient completed more than 90% of the exercise goal, the training intensity was increased).
Atorvastatin attenuates cardiac hypertrophy through AMPK/miR-143-3p/Bcl2 axis
Published in Archives of Physiology and Biochemistry, 2021
Jingang Sun, Cuicui Zhang, Zhigang Zhang
Atorvastatin was firstly launched as a lipid-lowering agent and used as the most commonly prescribed statin drug throughout the world (Ray and Cannon 2005, Horwich and MacLellan 2007). It was demonstrated that atorvastatin reduced the risk of myocardial infarction, stroke, and death (Amarenco et al. 2006). The study of Tian et al. further indicated that the effect of atorvastatin on cardiac tissues was exerted via AMPK/Foxo1-mediated suppression of miR-143-3p, which is a miR member critically involved in the development of cardiac hypertrophy (Tian et al. 2016, Yu et al. 2018). Anti-apoptosis was one of anti-hypertrophy effects of atorvastatin (Yu et al. 2018). Bcl2 is a “star” factor in regulating cell death (apoptosis). It was acceptable to suppose that the anti-apoptosis effect of atorvastatin might depend on the increased expression of Bcl2 mediated by AMPK/miR-143-3p pathway. Here, we studied the biological function of AMPK/miR-143-3p/Bcl2 axis in TAC model with or without Atorvastatin treatment, suggesting a conceivable mechanism of atorvastatin in anti-hypertrophy.
Dual loading of Nigella sativa oil-atorvastatin in chitosan–carboxymethyl cellulose nanogel as a transdermal delivery system
Published in Drug Development and Industrial Pharmacy, 2021
Fereshteh Bagheri, Sara Darakhshan, Saharnaz Mazloomi, Behrang Shiri Varnamkhasti, Reza Tahvilian
Atorvastatin, as a second-generation synthetic statin, prevents the production of cholesterol in the liver [14], and decreases cardiovascular problems [15]. However, growing pieces of evidence show that the beneficial effect of atorvastatin cannot be merely attributed to these effects [14]. This drug has also been reported to have anti-inflammatory, immunomodulatory, and antioxidant properties [16–18]. Owing to its diverse effects, atorvastatin has been suggested to be used in various pathological conditions such as sepsis, arthritis rheumatoid, and psoriasis [19,20]. Moreover, a number of studies on animal and human have been shown that atorvastatin can direct, manage, and accelerate the wound healing process [19,21,22]. However, the risk of hydrolysis, photolysis, oxidation, and the topical or transdermal administration of atorvastatin require applying the novel nanocarrier systems for having a more efficient delivery and controlling the release [23,24]. In a study by Morsy et al., results showed that skin permeation and wound healing potential of atorvastatin was significantly enhanced when formulated into nanoemulgel when compared to basic gel or emulgel formulations [25].