Is there clinical benefit to routine enzyme testing of patients on statins?

Asher Elhayany, Ram Avraham Mishaal, Shlomo Vinker

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objective: Statin-treated patients undergo frequent laboratory tests. This study evaluated the clinical impact of abnormal liver or muscle enzyme results. Research design and methods: This clinical process evaluation study took place in six primary care clinics in Israel. Four hundred and eight patients (average age 63.8 ± 10.9 years) undergoing statin treatment, with at least one enzyme level > 10% normal, were categorized by symptomatology possibly related to statins. Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and creatine phosphokinase were measured. Management and etiology of the elevation were assessed. Main outcome measures: Changes in statin regimen. Results: Thirty-six (8.8%) patients were symptomatic at the index encounter. One enzyme was elevated in 74.8%. Patients experiencing side effects had more repeat tests (36.1 vs 17.7%, p < 0.001). Musculoskeletal symptoms resulted in a change in treatment more than digestive symptoms did (73.3 vs 16.7%, p < 0.001). Of 40 (9.8%) patients who had additional evaluation, two symptomatic patients had treatment changes. Conclusions: There is little practical value in routine follow-up enzyme tests for patients on statins. Our findings strengthen reports that recommend muscle and liver enzyme tests for symptomatic patients only.

Original languageEnglish
Pages (from-to)185-190
Number of pages6
JournalExpert Opinion on Drug Safety
Issue number2
StatePublished - 1 Mar 2012
Externally publishedYes


  • Clinical practice
  • Creatine phosphokinase
  • Liver enzymes
  • Side effects
  • Statins

ASJC Scopus subject areas

  • Pharmacology (medical)


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