A 35-year-old woman on atorvastatin 40 mg daily presents with acute myalgia, proximal weakness, and dark urine. Vital signs: BP 128/82, HR 92, RR 16, Temp 37.2°C, SpO2 98%. Laboratory studies reveal creatine kinase 3500 U/L, urinalysis positive for myoglobin, and serum creatinine 1.1 mg/dL. She denies recent trauma or strenuous exercise. Which mechanism best explains her muscle injury in the context of statin therapy?
- A)Increased membrane fluidity from reduced cholesterol
- B)Depletion of CoQ10 leading to impaired mitochondrial ATP productionGABARITO
- C)Inhibition of carnitine palmitoyltransferase I
- D)Direct inhibition of muscle phosphofructokinase
- E)Accumulation of HMG-CoA causing lipotoxicity
Explicação
Statin-induced myopathy, particularly statin-induced necrotizing myopathy, is partly explained by depletion of CoQ10 (ubiquinone), which is synthesized via the same mevalonate pathway that statins inhibit. CoQ10 is essential for mitochondrial electron transpor... Ver explicação completa e trilha adaptativa →