Dyslipidemias and HMG-CoA reductase inhibitor prescription in heart transplant recipients.

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 >or=15 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.