A 63-Year-Old Man With STEMI and Muscle Cramps Wants to Reduce His Statin Dose

Editor's Note: Based on the 2013 Blood Cholesterol, Lifestyle Management, Obesity, and Risk Assessment Guidelines.

A 63-year-old man is seen in the office 2 weeks after a ST-elevation myocardial infarction (MI). A former smoker with hypertension, he was discharged on atorvastatin 80mg daily, dual anti-platelet therapy, long-acting metoprolol, and an ACE inhibitor. One year before the acute MI, he was prescribed simvastatin 40 mg which was then increased to simvastatin 80 mg. He stopped the simavastatin 80 mg 2 weeks later after developing muscle cramps in his legs. At that time he was also on a calcium channel blocker for his hypertension. Although he has no muscle symptoms since he started the atorvastatin 80 mg, he is concerned about having had muscle cramps in the past on a statin and would like to decrease the atorvastatin to 20 mg daily.

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