39 MYALGIA DOES NOT CORRELATE WITH CREATINE PHOSPHOKINASE LEVELS IN STATIN TREATED PATIENTS

BackgroundMyopathic pain is a feared complication of HMG CoA reductase inhibitor (statin) therapy, due to associated rhabdomyolysis. The incidence of rhabdomyolysis is low, but myalgias, fatigue and weakness are frequent in statin treated patients and often play a decisive role in patient adherence to the prescribed treatment. Preliminary evidence has implicated mitochondrial defects in ATP production as responsible for these symptoms in patients on chronic statin therapy.MethodsProspectively studied patients on chronic statin therapy (with simvastatin or atorvastatin) with complaints of muscle pain, weakness, fatigue had their myalgias graded on a validated pain scale (range 0-10). Creatine phosphokinase (CPK) values were obtained and correlated with the patients' self-rated discomfort, statin choice and dosage. The patients participated in a randomized blinded trial of coenzyme Q10 or vitamin E supplementation with the statin choice and dosage held constant. Pain scale and CPK were repeated at the end of 1 month. Statistical testing included measurement of correlation coefficients, Fisher exact test with significance at p