Myolysis and Acute Renal Failure in a Heart-Transplant Recipient Receiving Lovastatin

To the Editor: Lovastatin, a new cholesterol-lowering drug that inhibits 3-hydroxy-3-methylglutaryl-CoA reductase,¹ can cause myositis and elevations in serum creatine kinase levels by means of an unknown mechanism² in a small number (<0.5 percent) of patients. Severe muscle damage and acute renal failure due to lovastatin have not been reported. Our patient, a 53-year-old man with heterozygous familial hypercholesterolemia, received a cardiac allograft in July 1986. Because of refractory hypercholesterolemia (total plasma cholesterol, 468 ml per deciliter [12.6 mmol per liter]; triglycerides, 236 mg per deciliter [2.67 mmol per liter]), he was started on lovastatin (20 mg twice daily) in.