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Statin and exercise prescription

Correspondence
The fi rst case of H7N9
high H7N9 viral loads (4·5–51·4 × 107 side-eff ects of statins. Sinzinger and copies per mL) were found in the O’Grady1 reported statin intolerance infl uenza in Taiwan
two sputum specimens and one in elite soccer players,2 and the Published Online
We report here the fi rst case of H7N9 throat-swab specimen (collected on PRIMO study3 reported a higher April 26, 2013 April 20 and April 22, respectively) incidence of statin induced myalgia S0140-6736(13)60943-5 A 53-year-old male patient was while the viral load was undetectable in subjects performing intense sports.
admitted because of fever for 3 days in the blood specimens collected daily We have reported previously that after returning from Suchow, Jiangsu between April 20 and 23.
H7N9 might spread to other creatine kinase produced by exercise.4 had been otherwise well except for a areas beyond Shanghai, China. Due Consequently physicians must weight history of hypertension and chronic to the rapidly progressing lower relative benefi ts of physical activity hepatitis B virus infection. The patient respiratory tract infections in infected and statins in active individuals. did not report a history of contact individuals,1,2 extensive preventive Physical activity could produce greater with sick persons or animals during eff orts are needed to prevent further risk reduction than statins. The the travel. He began to get fever and spreading of H7N9.
signifi cant eff ect of physical activity general malaise on April 12. He had no We declare that we have no confl icts of interest.
changsc@ntu.edu.tw
for H7N9 with real-time PCR on Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University April 17 and April 20, respectively. The College of Medicine, Taipei, Taiwan (S-YC, P-HL); TMHE and BAP declare that they have no confl icts fi rst chest radiograph was normal. and Internal Medicine, National Taiwan University of interest. PDT has received research grants from Hospital and National Taiwan University College of the National Institutes of Health, GlaxoSmithKline, Treatment with oseltamivir was Medicine, Taipei, Taiwan (J-CT, C-CH, S-CC) Anthera, Genomas, Roche, Aventis, Novartis, Regeneron and Sanofi ; has served as a consultant Gao R, Cao B, Hu Y, et al. Human infection with for AstraZeneca, Regeneron, Merck, Roche, a novel avian-origin infl uenza A (H7N9) virus. Genomas, Abbott, Runner’s World, Genzyme, N Engl J Med. 2013; published online April 11. DOI:10.1056/NEJMoa1304459.
Sanofi , Pfi zer, and GlaxoSmithKline; has received Guan Y, Farooqui A, Zhu H, Dong W, Wang J, Kelvin DJ. H7N9 incident, immune status, the AstraZeneca, GlaxoSmithKline, and Kowa; and owns stock in General Electric, JA Wiley Publishing, pandemic. J Infect Dev Ctries 2013; 7: 302–07.
Follow-up chest radiographs showed progressive bilateral lower-lung Thijs M H Eijsvogels, Beth A Parker, National Taiwan University Hospital Statin and exercise
pthomps@harthosp.org
on April 20. The dose of oseltamivir prescription
Henry Low Heart Center, Hartford Hospital, Hartford, CT 06102, USA (TMHE, BAP, PDT); Radboud University Nijmegen Medical Centre, daily. Endotracheal intubation and Peter Kokkinos and colleagues (Feb 2, Nijmegen, The Netherlands (TMHE); and mechanical ventilator support was p 394)1 describe the interactive eff ects Department of Health Sciences, University of given on arrival because of respiratory of fi tness and statins on mortality risk Hartford, West Hartford, CT, USA (BAP)failure. Ceftazidime and levofl oxacin in veterans with dyslipidaemia. They 1 Kokkinos PF, Faselis C, Myers J, Panagiotakos D, were started, although microbiological report that increasing physical activity Doumas M. Interactive eff ects of fi tness and statin treatment on mortality risk in veterans with dyslipidaemia: a cohort study. Lancet saturation worsened despite use of levels and total mortality, but that the 2013; 381: 394–99.
Sinzinger H, O’Grady J. Professional athletes supplemental O₂ at O₂ fraction of combination of these interventions is suff ering from familial hypercholesterolaemia 100%. Inhalational NO was added superior to either alone. The authors rarely tolerate statin treatment because of on April 21 without benefi t. Chest conclude that prescription of physical muscular problems. Br J Clin Pharmacol 2004;
57: 525–28.
radiography and sonography did not activity is as important as prescribing 3 reveal pneumothorax. He was put on statins in groups with increased Begaud B. Mild to moderate muscular symptoms with high-dosage statin therapy in hyperlipidemic patients–the PRIMO study.
Cardiovasc Drugs Ther 2005; 19: 403–14.
Submissions should be
made via our electronic
specimen was subtyped as H7N9 have the best cardiovascular risk Zimet RJ, Staggers J, Guyton JR. Lovastatin submission system at
with the protocol provided by WHO profi le, but they might be more increases exercise-induced skeletal muscle http://ees.elsevier.com/
Collaborating Centre in Beijing. Very vulnerable to the skeletal muscle injury. Metabolism 1997; 46: 1206–10.
thelancet/
www.thelancet.com Vol 381 May 11, 2013

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