CoQ10 and L-carnitine for Statin Myalgia?

James J DiNicolantonio

Disclosures

Expert Rev Cardiovasc Ther. 2012;10(10):1329-1333. 

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SEARCH

The SEARCH study was a genome-wide association study that identified two variants in the SLCO1B1 gene.[13]SLCO1B1 encodes for the organic anion-transporting polypeptide, which mediates statin uptake into hepatocytes.[13] The rs41419056 allele and the rs2306283 allele have been shown to decrease statin liver uptake.[13] This reduction leads to lower statin concentrations in the liver and increases statin concentrations out in the blood. Genetic variations in the SLCO1B1 gene have been shown to increase statin area under the curve (AUC) by 106% and reduce their ability to lower cholesterol.[14] Having these SNPs was also associated with a mild decrease in the efficacy of the statin (as far as lowering LDL) and an increased risk of myopathy.[13] The prevalence of the rs41419056 C allele in the population was 15%. The odds ratio for myopathy was 4.5 per copy of the C allele, and 16.9 in CC compared with TT homozygotes. More than 60% of these myopathy cases could be attributed to the C variant. In summary, patients who have the C allele of the rs4149056 polymorphism are at a greater risk for statin myopathy.[13]

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