TY - JOUR
T1 - Treatment of hyperlipidemia after heart transplantation and rationale for the heart transplant lipid registry
AU - Ballantyne, Christie M.
AU - Bourge, Robert C.
AU - Domalik, Leslie J.
AU - Eisen, Howie J.
AU - Fishbein, Daniel P.
AU - Kubo, Spencer H.
AU - Lake, Kathleen D.
AU - Radovancevic, Branislav
AU - Taylor, David O.
AU - Ventura, Hector O.
AU - Yancy, Clyde W.
AU - Young, James B.
N1 - Funding Information:
From the Section of Atherosclerosis, Department of Medicine, Baylor College of Medicine, Houston, Texas, on behalf of the Heart Transplant Lipid Registry. This work was supported by a grant from Merck and Co., Inc, West Point, Pennsylvania. Manuscript received December 15, 1995; revised manuscript received and accepted March 22, 1996.
PY - 1996
Y1 - 1996
N2 - Hyperlipidemia occurs frequently after heart transplantation, and accelerated coronary artery disease remains the major cause of morbidity and mortality in patients who survive more than 1 year after heart transplantation. However, the risks and benefits of lipid-lowering therapy after heart transplantation remain poorly defined, and national guidelines for lipid-lowering drug therapy do not specifically address treatment of dyslipidemia in transplant recipients. Since the initial reports in the 1980s of rhabdomyolysis in heart transplant patients receiving high-dosage lovastatin, results of 11 post-transplantation series that used lovastatin, simvastatin, or pravastatin at lower dosages as drug monotherapy have been published. These studies have shown an overall 1% incidence of rhabdomyolysis, defined as creatine kinase > 10 times the upper limit of normal plus muscle symptoms. One randomized, controlled prospective trial has investigated the effects of lipid-lowering pharmacotherapy on patient outcome in cardiac transplant recipients. At 1 -year follow-up in this nonblinded, single-center trial, patients treated with pravastatin (20 or 40 mg/day) initiated within 2 weeks of transplantation had a significant reduction in mortality rate and a significantly lower incidence of transplant arteriopathy. A number of important issues remain unanswered regarding treatment guidelines in patients with hyperlipidemia after heart transplantation. In January 1995 we began the Heart Transplant Lipid Registry, with 12 participant centers, to gather data prospectively on the efficacy and safety of lipid-lowering drugs in the treatment of dyslipidemia after heart transplantation.
AB - Hyperlipidemia occurs frequently after heart transplantation, and accelerated coronary artery disease remains the major cause of morbidity and mortality in patients who survive more than 1 year after heart transplantation. However, the risks and benefits of lipid-lowering therapy after heart transplantation remain poorly defined, and national guidelines for lipid-lowering drug therapy do not specifically address treatment of dyslipidemia in transplant recipients. Since the initial reports in the 1980s of rhabdomyolysis in heart transplant patients receiving high-dosage lovastatin, results of 11 post-transplantation series that used lovastatin, simvastatin, or pravastatin at lower dosages as drug monotherapy have been published. These studies have shown an overall 1% incidence of rhabdomyolysis, defined as creatine kinase > 10 times the upper limit of normal plus muscle symptoms. One randomized, controlled prospective trial has investigated the effects of lipid-lowering pharmacotherapy on patient outcome in cardiac transplant recipients. At 1 -year follow-up in this nonblinded, single-center trial, patients treated with pravastatin (20 or 40 mg/day) initiated within 2 weeks of transplantation had a significant reduction in mortality rate and a significantly lower incidence of transplant arteriopathy. A number of important issues remain unanswered regarding treatment guidelines in patients with hyperlipidemia after heart transplantation. In January 1995 we began the Heart Transplant Lipid Registry, with 12 participant centers, to gather data prospectively on the efficacy and safety of lipid-lowering drugs in the treatment of dyslipidemia after heart transplantation.
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U2 - 10.1016/S0002-9149(96)00358-X
DO - 10.1016/S0002-9149(96)00358-X
M3 - Article
C2 - 8806337
AN - SCOPUS:10644219635
SN - 0002-9149
VL - 78
SP - 532
EP - 535
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 5
ER -