To investigate the etiological factors and clinical characteristics of statin-associated myopathy in elderly patients.

A retrospective analysis was performed on elderly patients with statina-ssociated myopathy who were treated in the internal medicine department of our hospital from January 2017 to June 2024. Data including etiology, clinical manifestations, treatment process and prognosis were collected and analyzed.

A total of 21 elderly patients with statina-ssociated myopathy were enrolled, including 13 males and 8 females, with an average age of (77.33±9.61) years. Among them, 5 patients were diagnosed with rhabdomyolysis. According to the type of statin taken, patients were divided into 5 groups: atorvastatin group, rosuvastatin group, simvastatin group, pitavastatin group and Xuezhikang group. All patients received monotherapy without overlapping or combined use of different statins. The duration of statin therapy at onset ranged from 2 weeks to 10 years. Precipitating factors included infection, concomitant medications, stress and exercise. Among them, 12 cases were related to infection (9 pneumonia, 2 urinary tract infections, 1 intestinal infection), and 2 cases were associated with concomitant medications (quetiapine and cyclosporine A, respectively). Most patients had multiple comorbidities: hypertension in 90.48% (19 cases/21 cases), type 2 diabetes mellitus in 66.67% (14 cases/21 cases), coronary heart disease in 47.62% (10 cases/21 cases), and chronic kidney disease in 23.81% (5 cases/21 cases). Patients were on multiple concomitant medications, with a mean of 6 drugs used. Acute kidney injury occurred in 4 patients with myopathy and in 5 patients with rhabdomyolysis. After comprehensive treatment including statin discontinuation, fluid replacement, urine alkalinization and blood purification, all patients improved and no deaths occurred. Serum creatinine in patients with acute kidney injury returned to normal or baseline levels before onset.

Elderly patients with acute infection, concomitant medications and multiple comorbidities should be closely monitored for the risk of statinassociated myopathy or rhabdomyolysis. Acute kidney injury is common in such elderly patients. Early discontinuation of statins and comprehensive treatment including symptomatic fluid infusion and blood purification can significantly improve patient prognosis.