Key result
Statins alone or with LDL apheresis may help prevent transplant coronary artery disease.
Why the study?
The complex interactions between lipoprotein metabolism, immunosuppressive therapy, and inflammation after heart transplantation and the benefits of lipid-lowering therapy require examination.
Does lipid-lowering therapy and newer immunosuppressive regimens prevent transplant coronary artery disease in heart transplant recipients?
Does lipid-lowering therapy and newer immunosuppressive regimens prevent transplant coronary artery disease in heart transplant recipients?
This review highlights the potential of lipid-lowering therapies and newer immunosuppressive agents to mitigate dyslipidemia and prevent transplant coronary artery disease after heart transplantation.
Newer immunosuppressants may offer lipid advantages post-transplant; leaves open whether lipid-lowering therapy improves clinical outcomes.
In this review we examine the complex interactions between lipoprotein metabolism, immunosuppressive drug therapy, and inflammation and the potential benefits of lipid-lowering drug therapy after heart transplantation. The newer formulations of cyclosporine, Neoral (Novartis Pharmaceuticals; Basle, Switzerland), and other newer agents such as tacrolimus may have advantages in regard to lipid metabolism as compared with traditional triple-drug immunosuppression. Lipoprotein levels may influence both the toxicity and efficacy of cyclosporine. Dyslipidemia may adversely influence inflammation and rejection in the allograft. Two recent clinical trials have shown that lipid-lowering therapy with a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor alone or in combination with low-density lipoprotein apheresis may confer significant benefits toward preventing transplant coronary artery disease.
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Ballantyne et al. (1997) conducted a review in Lipid perturbation after cardiac transplantation. Lipid-lowering drug therapy was evaluated. Lipid-lowering therapy with an HMG-CoA reductase inhibitor alone or with LDL apheresis may confer significant benefits toward preventing transplant coronary artery disease.
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