Could a simple blood test predict statin muscle pain?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Age at least 18 years. 2. A representative of the Caucasian race. 3. The patient agrees to participate in the study by signing an informed consent form for participation in the study. (The patient may only be included in the muscle biopsy sub-study if the relevant additional informed consent form has also been signed.) 4. Specific inclusion criteria for each of the study subgroups: 1. Group A: patients have elevated creatine kinase levels \>1.5x above the upper limit of normal (women \>325 U/L and men \>504 U/L) with or without muscle symptoms that have no other obvious explanation (including intense physical activity in the last 7 days). 2. Group B: atorvastatin 40-80 mg or rosuvastatin 20-40 mg monotherapy for at least 8 weeks at a constant dose and no muscle symptoms (pain, weakness, fatigue, cramps) during this period, CK \<200 U/L. 3. Group C: no lipid-lowering agents have been used during the last year and there have been no muscle symptoms (pain, weakness, fatigue, cramps) of unknown origin lasting \>1 week during this period, CK \<200 U/L. Exclusion Criteria: 1. Any disease that, in the opinion of the investigator, could also cause a significant increase in CK or muscle symptoms. 2. Use of other cholesterol-lowering agents specific to each of the study groups: 1. Group A: use of red yeast rice extract, fibrates, or bempedoic acid within the last 8 weeks. 2. Group B: use of other non-statin cholesterol-lowering agents (red yeast rice extract, ezetimibe, fibrates, PCSK9 inhibitors, inclisiran, bempedoic acid) in the last 8 weeks. 3. Group C: use of any cholesterol-lowering agents (statins, red yeast rice extract, ezetimibe, fibrates, PCSK9 inhibitors, inclisiran, bempedoic acid) in the last 12 weeks. 3. Intense physical activity in the last 7 days. 4. Acute myocardial infarction or stroke in the last 4 weeks. 5. Major surgery within the last 4 weeks (invasive cardiac procedures are not an exclusion criterion). 6. Patients with severe illness that, in the investigator's opinion, may significantly affect the patient's overall metabolism (e.g., active malignancy, terminal heart failure, etc.). 7. Excessive alcohol consumption (binge drinking or \>7 units of alcohol per day) within the last year. 8. Use of other substances or medications known to have direct myotoxic effects (e.g., fibrates, cyclosporins, labetalol, propofol, procainamide, interferon-alpha, hydroxyurea, zidovudine, colchicine, vincristine, amiodarone, corticosteroids) or that may affect CK elevation. 9. Use of meldonium within the last 2 months.