Dyslipidemias and HMG-CoA Reductase Inhibitor Prescription in Heart Transplant Recipients

Abstract

BACKGROUND:

The treatment of dyslipidemias in orthotopic heart transplant (OHT) recipients is not highlighted in the National Cholesterol Education Program Adult Treatment Panel guidelines. Emerging data suggest that hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) safely reduce the risk of transplant rejection and coronary artery vasculopathy in OHT patients.

OBJECTIVE:

To assess the proportion of patients from our institution reaching the low-density lipoprotein cholesterol (LDL-C) target of <100 mg/dL, evaluate the impact of statins in reaching this goal, and evaluate the prescribing practice for statins in US OHT centers.

METHODS:

The management of dyslipidemia of OHT recipients followed at our institution was retrospectively evaluated. In addition, the use of statins in adult OHT centers in the US that performed ≥1 5 OHTs per year was assessed through a survey.

RESULTS:

Of the 328 patients from our institution, 58.5% achieved an LDL-C <100 mg/dL. Patients prescribed statins were more likely to reach this goal (p < 0.01). A total of 85.0% of centers responding to the survey use statins as a part of their post-OHT protocol, primarily to reduce coronary artery vasculopathy (70.6%).

CONCLUSIONS:

Due to the potential for improved outcomes, a large proportion of patients are prescribed a statin. Our results support previous findings that statins are safe and effective in reducing LDL-C in the management of dyslipidemias in OHT recipients. Nonetheless, dyslipidemias are suboptimally managed in many post-OHT patients.