Are patients undergoing treatment of hyperlipidaemia with statins the best candidates for early cardiac rehabilitation? Rafał Celiński1, Anna Grzywa-Celińska2, Wojciech Myśliński2, Andrzej Dybała2, Jerzy Mosiewicz2 Review paper 1Department of Cardiology, Cardinal Wyszynski’s Hospital, Lublin Poland 2Chair and Department of Internal Diseases, Medical University of Lublin, Poland Submitted: 7 February 2010 Accepted: 24 July 2010 Arch Med Sci 2011; 7, 5: 756-759 DOI: 10.5114/aoms.2011.25548 Copyright © 2011 Termedia & Termedia A b s t r a c t The role of statins in the primary and secondary prevention of cardiovascular events is well known. An important adverse event associated with statin treatment is myopathy; intensive physical effort in patients treated with statins increases the risk of muscle injury/myopathy. In this article we discuss the benefits and risks associated with statin treatment in patients undergoing cardiac rehabilitation after acute coronary syndromes and/or coronary revascularization procedures. In our opinion, the benefits of the secondary prevention of coronary heart disease achieved with statins seem to outweigh the hazards associated with statin therapy. The careful selection of patients for both treatment with statins and the gradual intensification of physical training in the course of cardiac rehabilitation appears to constitute an important element of the therapeutic approach. Key words: statins, myopathy, early cardiac rehabilitation. Introduction Physical activity is still an underestimated primary and secondary prevention factor for the reduction of the risk of acute coronary events. The aim of cardiac rehabilitation is the shortening of treatment time after acute coronary syndromes (ACS), the independent functioning and occupational activity for as many patients as possible, as well as the prevention of disability and the consequent financial burden on the state [1]. Data from the “Report of the condition of cardiac rehabilitation in Poland” in 2004 [2] confirm the high effectiveness of cardiac rehabilitation in patients with coronary heart disease (CHD). Cardiac rehabilitation may lower cardiac mortality by 20-25% and the percentage of deaths during the first year after myocardial infarction (MI) by 35%. Most patients after ACS are automatically qualified for statin therapy; some of them start the treatment at almost the same time as the beginning of their cardiac rehabilitation. Some studies have reported an increased prevalence of myopathy in patients under intensive hyperlipidaemia treatment [3]. Thus, the risk of statin-induced myopathy should be taken into account in all patients treated with statins with simultaneous intensive cardiac rehabilitation, especially in older patients. Correspondence author: Rafał Celiński PhD Department of Cardiology Cardinal Wyszynski’s Hospital 100 Kraśnicka 20-718 Lublin, Poland e-mail: rcelinski@op.pl