A 62-year-old man with a history of myocardial infarction is started on a statin for secondary prevention. After 4 weeks of therapy, his LDL decreases by 35%, but he develops myalgias and elevated creatine kinase (2000 IU/L). Which of the following represents the mechanism by which statins caused this adverse effect?
- A)Increased acetyl-CoA carboxylase activity leading to fatty acid accumulation
- B)Increased production of oxygen-free radicals in skeletal muscle
- C)Direct inhibition of muscle lipoprotein lipase
- D)Reduced CoQ10 synthesis impairing muscle glucose metabolism
- E)Depletion of mevalonate pathway intermediates required for muscle mitochondrial functionGABARITO
Explicação
Statin-induced myopathy results from inhibition of HMG-CoA reductase, which blocks the mevalonate pathway. This pathway produces not only cholesterol but also intermediates like isoprene groups (for protein prenylation) and CoQ10 that are essential for mitocho... Ver explicação completa e trilha adaptativa →