This review examines the safe use of statin therapy in the hospitalized patient. Available data support initiation of statin therapy during hospitalization in patients with acute coronary syndromes or established cardiovascular disease and in high-risk patients with diabetes mellitus and chronic kidney disease (except for those on maintenance hemodialysis). Because of the increased risk of cardiovascular disease, statins are given to solid-organ transplant survivors and those treated with protease inhibitors for human immunodeficiency virus. However, in the multidrug, acute illness hospital environment, safety considerations become paramount. We review the essentials of statin metabolism and drug-drug interactions to provide the hospital physician with information to minimize potentially serious adverse statin effects.
- Statin safety
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