Quarta Candida C, Potena Luciano, Grigioni Francesco, Scalone Antonella, Magnani Gaia, Coccolo Fabio, Fallani Francesco, Russo Antonio, Branzi Angelo
Institute of Cardiology, University of Bologna and Hospital S. Orsola-Malpighi, Bologna, Italy.
J Heart Lung Transplant. 2008 Jun;27(6):685-8. doi: 10.1016/j.healun.2008.02.014. Epub 2008 Apr 28.
Although statins have proven efficacy in lowering lipids and improving survival in heart transplantation (HT) recipients, potential drug interactions may limit efficacy and reduce tolerability. This observational study explored the efficacy and tolerability of ezetimibe (10 mg/day) combined with simvastatin (10 or 20 mg/day) prescribed to HT recipients with intolerance to statins (n = 11) or inadequate lipid control despite high-dose statins (n = 14). Substantial reductions in lipid levels were apparent after 2 months (total cholesterol, -22%; low-density lipoproteins, -28%; triglycerides, -31%) and were maintained at 6 months. Reductions were significant in both subgroups of recipients; the vast majority (12 of 14, 85%) of recipients with a history of statins intolerance were able to tolerate ezetimibe plus low-dose simvastatin. This study provides suggestive evidence that treatment with ezetimibe plus low-dose simvastatin is well tolerated by HT recipients and may be effective for treatment of dyslipidemia in HT recipients with statins intolerance or resistance.
尽管他汀类药物已被证明在降低心脏移植（HT）受者血脂和提高生存率方面有效，但潜在的药物相互作用可能会限制疗效并降低耐受性。这项观察性研究探讨了依折麦布（10毫克/天）联合辛伐他汀（10或20毫克/天）对他汀类药物不耐受（n = 11）或尽管使用高剂量他汀类药物但血脂控制不佳（n = 14）的HT受者的疗效和耐受性。2个月后血脂水平显著降低（总胆固醇，-22%；低密度脂蛋白，-28%；甘油三酯，-31%），并在6个月时维持。两个受者亚组的血脂水平均显著降低；绝大多数（14例中的12例，85%）有他汀类药物不耐受史的受者能够耐受依折麦布加低剂量辛伐他汀。这项研究提供了提示性证据，表明依折麦布加低剂量辛伐他汀治疗对HT受者耐受性良好，可能对他汀类药物不耐受或抵抗的HT受者的血脂异常治疗有效。
