Abstract
With the aim of assessing the effectiveness and safety of lovastatin in patients with hypercholesterolemia after heart transplantation, as well as the potential differences in the lipid-lowering effect of lovastatin between patients with or without pretransplant coronary artery disease (CAD), we studied 63 heart transplant patients who had serum total cholesterol >250 mg/dl in spite of dietary therapy. Mean age of subjects was 47 ± 2 years. Triple-drug immunosuppressive therapy consisted of cyclosporine, azathioprine, and steroids. Thirty-nine patients (62%) had pretransplant CAD and 24 (38%) did not. Pretreatment serum lipid levels were: total cholesterol, 302 ± 32 mg/dl; low-density lipoprotein (LDL) cholesterol, 201 ± 35 mg/dl; high-density lipoprotein (HDL) cholesterol, 60 ± 19 mg/dl; triglycerides, 205 ± 86 mg/dl; and total/HDL cholesterol ratio, 5.4 ± 1.6. Patients received 10 to 40 mg/day of lovastatin (mean dose 17 ± 6) for 13 ± 4 months. There were no serious adverse events. At 3 months, lovastatin decreased total cholesterol by 15% (p < 0.001), LDL cholesterol by 21% (p < 0.001), triglycerides by 17% (p < 0.05), and total/HDL cholesterol ratio by 17% (p < 0.001), and increased HDL cholesterol by 3% (NS). Although lovastatin was effective in both patients with pretransplant CAD and non-CAD, analysis of its effect in each subgroup (CAD and non-CAD) revealed that its lipid-lowering effect was higher for non-CAD patients (−20% vs −12% for total cholesterol, and −27% vs −17% for LDL cholesterol, both p < 0.01). Thus, lovastatin was useful and safe for the treatment of hypercholesterolemia after heart transplantation, although it was more effective in patients without pretransplant CAD.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have