Serial evaluation of lipid profiles and risk factors for development of hyperlipidemia after cardiac transplantation

Abstract

To determine the prevalence, time course and factors responsible for hyperlipidemia after heart transplantation, 83 consecutive 1-year survivors were studied. By 1 year, 83% of patients had serum total cholesterol levels >5.2 mmol/liter (200 mg/dl) and 28% of the patients had serum total cholesterol higher than the age- and sex-matched ninety-fifth percentile. At the end of 1-year follow-up, serum total cholesterol correlated with the recipient age (p < 0.0001), the preoperative cholesterol level (p < 0.001), the actual dose of maintenance prednisone at 1 year (p < 0.02) and the cumulative 1-year steroid dose (p < 0.03). Similarly, the serum triglyceride level at 1 year correlated with the pretransplant level of serum triglycerides (p < 0.0001), recipient age (p < 0.03) and cumulative 1-year steroid dose (p < 0.03). Patients with a pretransplant diagnosis of coronary artery disease had a significantly higher level of serum total cholesterol and triglyceride levels at 1 year (p < 0.02 and p < 0.03, respectively). Heart transplant recipients with body mass index ≥25 kg/m 2 also presented with significantly elevated serum total cholesterol and triglyceride levels at 1 year compared with nonobese patients (p < 0.01 and p < 0.002, respectively). Hyperlipidemia occurs frequently and is detected within the first month after heart transplantation. Optimal management of this problem requires further study.