Statins and Cardiomyopathy: Fact or Fiction?

Washington, DCIt was a little more than a year ago that we were telling you about a concern with regard to statins and myopathy—or injury to the muscle—when taken above a certain dosage and in concert with other medications. To that point, the US Food and Drug Administration (FDA), on March 19 of last year, released an updated warning for myopathy and rhabdomyolysis associated with statins, a class of cholesterol-lowering drugs that includes Zocor.

But there's another concern. It seems that statins are not all they're cracked up to be—especially in light of a potential link between statins and cardiomyopathy.

Zocor simvastatin, for example, has been previously linked to Zocor liver damage and Zocor muscle damage. As muscles go, the heart is the most important muscle we have. And apparently, according to various people in the medical profession, statins can also have an impact on the heart muscle as well.

Statins are used to lower levels of what is popularly known as ''bad cholesterol'' thought to have a negative impact on heart health. However, there are various positions within the medical community pertaining to statin use and their effectiveness for heart health—and not everyone is a fan.

Peter H. Langsjoen, MD, submitted a paper to the FDA nine years ago on the relationship of statins and cardiomyopathy. In a tersely worded introduction dated July 8, 2002, Dr. Langsjoen points out that statins negatively impact levels of Coenzyme Q10 (CoQ10), an enzyme important to good heart health.

"In my practice of 17 years in Tyler, Texas, I have seen a frightening increase in heart failure secondary to statin usage, 'statin cardiomyopathy.' Over the past five years, statins have become more potent, are being prescribed in higher doses, and are being used with reckless abandon in the elderly and in patients with 'normal' cholesterol levels," Dr. Langsjoen wrote in 2002. "We are in the midst of a CHF epidemic in the US with a dramatic increase over the past decade. Are we causing this epidemic through our zealous use of statins? In large part I think the answer is yes."

It has been previously reported that the effectiveness of statins for heart failure patients continues to be hotly debated. Critics note that heart failure patients have largely been excluded from major, randomized clinical trails of statins. Thus, questions remain.

Dr. Langsjoen is more blunt.

"Statins kill people—lots of people—and they wound many, many more."

Byron J. Richards, in a blog entry on Wellness Resources, refers to a 2007 study co-authored by Dr. Langsjoen. Richards says, "The issue of statins interfering with heart health—and the major rise in heart failure in older patients taking statins, is a problem medical people would prefer to think does not exist."

The study, "Littarru GP, Langsjoen P. Coenzyme Q10 and statins: biochemical and clinical implications, Mitochondrion 2007'' is associated with the Institute of Biochemistry, Polytechnic University of the Marche, Via Ranieri, 60131 Ancona, Italy.

As for Dr. Langsjoen, as part of his own peer-reviewed study in 2002 entitled, ''The clinical use of HMG CoA-reductase inhibitors (statins) and the associated depletion of the essential co-factor coenzyme Qlo; a review of pertinent human and animal data''—he came up with his own black box warning for statins sold in the US. In his view, it should read…

''Warning: HMG CoA reductase inhibitors block the endogenous biosynthesis of an essential co-factor, coenzyme Qlo, required for energy production. A deficiency of coenzyme Q 10 is associated with impairment of myocardial function, with liver dysfunction and with myopathies (including cardiomyopathy and congestive heart failure). All patients taking HMG CoA reductase inhibitors should therefore be advised to take 100 to 200 mg per day of supplemental coenzyme Qlo.''