Abstract 16704: Role of Statins in Heart Transplant Recipients: A Meta-analysis

Abstract

Introduction: Statins, through their immunomodulatory effects, may prevent cardiac allograft dysfunction in heart transplant recipients. Current International Society of Heart and Lung Transplantation (ISHLT) guidelines recommend the use of statins in these patients. Though several studies have demonstrated significant survival benefit with statin use, a pooled analysis evaluating the role of statins in heart transplant recipients has not been performed to date. We conducted a meta-analysis to study the effect of statins on outcomes in heart transplant recipients. Methods: We searched PubMed for all published studies comparing statins with controls in heart transplant recipients. Outcomes studied included all-cause mortality and hemodynamically significant / fatal rejection. All studies reporting these outcomes were included in the pooled analysis. Random effects model with Mantel-Haenszel method was used to analyze the outcomes. Results: We identified 9 studies (n = 2062) which compared outcomes in heart transplant recipients receiving statins (n = 1449) with that of those not receiving statins (n = 613). Of the 9 studies, 4 were randomized controlled trials and 5 were retrospective studies. There was no heterogeneity across the studies (mortality - I2 = 0%, rejection - I2 = 19%). The use of statins was associated with a significant reduction in all-cause mortality (OR 0.28, 95% CI 0.21-0.37, p < 0.0001). Statins also significantly decreased hemodynamically significant / fatal rejections (OR 0.41, 95% CI 0.25-0.69, p < 0.0001) Conclusion: Statins provide significant survival benefit and reduce cardiac allograft rejection in heart transplant recipients.