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Statin Rebound or Withdrawal Syndrome: Does It Exist?

Current Atherosclerosis Reports volume 13, pages 23–30 (2011)Cite this article

Abstract

Studies in vascular cells in culture and in laboratory animals revealed that statin discontinuation triggers a rebound deterioration of vascular function. Retrospective studies of patients admitted with an acute coronary syndrome revealed that stopping statins during the first days of admission was associated with worse outcomes. In a prospective, randomized controlled trial in patients with a hemispheric ischemic stroke, stopping statins for 3 days was associated with a 4.7-fold increase in the risk of death or dependency, greater neurological deterioration, and a larger infarct volume. Discontinuing statins during the post-operative period following major vascular surgery was associated with a higher incidence of myocardial ischemia, nonfatal myocardial infarction, and cardiovascular death. However, no increase in adverse outcomes was observed in patients with stable chronic coronary artery disease following statin treatment discontinuation. Despite some study limitations, the bulk of the evidence suggests that under conditions of severe acute vascular stress, removal of statins must be contraindicated.

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Disclosure

Andres Pineda reports no potential conflict of interest relevant to this article. Luigi Cubeddu reports no potential conflict of interest relevant to this article.

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Affiliations

  1. Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL, 33140, USA

    Andres Pineda & Andres Pineda

  2. Division of Cardiovascular and Metabolic Research, Health Profession Division, Nova Southeastern University, 3200 S. University Dr., Fort Lauderdale, FL, 33328, USA

    Luigi X. Cubeddu

Authors
  1. Andres Pineda
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  2. Luigi X. Cubeddu
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Correspondence to Luigi X. Cubeddu.

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Pineda, A., Cubeddu, L.X. Statin Rebound or Withdrawal Syndrome: Does It Exist?. Curr Atheroscler Rep 13, 23–30 (2011). https://doi.org/10.1007/s11883-010-0148-x

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  • DOI: https://doi.org/10.1007/s11883-010-0148-x

Keywords

  • Statins
  • Statin withdrawal
  • Acute coronary events
  • Acute ischemic stroke
  • Major vascular surgery