Sir GangaRam Hospital, New Delhi, 110060, India.
Indian Heart J. 2024 Mar;76 Suppl 1(Suppl 1):S93-S95. doi: 10.1016/j.ihj.2024.01.004. Epub 2024 Jan 8.
Solid organ transplant recipients face an increased risk of dyslipidemia, which contributes to cardiovascular complications. Commonly used drugs such as ciclosporin and tacrolimus can aggravate and cause dyslipidemia. Immunosuppressive drugs particularly ciclosporin and tacrolimus are also known to worsen dyslipidemia in transplant recipients. Mammalian target of rapamycin (mTOR) inhibitors like sirolimus and everolimus also alter lipid metabolism. Lifestyle and dietary modifications should be encouraged. Careful consideration of immunosuppressant choices is also vital to control dyslipidemia. Statins are recommended as first-line agents for lipid-lowering therapy, with consideration for potential drug interactions. Other options, such as ezetimibe and nicotinic acid, may be considered as alternatives. The management of dyslipidemia in renal transplant patients mainly involves statin therapy, although the clinical effectiveness in this population is not well-documented. Lifestyle modifications, careful drug selection, and statin therapy are key components in managing dyslipidemia in solid organ transplant patients.
实体器官移植受者面临血脂异常风险增加,这会导致心血管并发症。环孢素和他克莫司等常用药物可加重并导致血脂异常。免疫抑制剂,特别是环孢素和他克莫司,也已知会使移植受者的血脂异常恶化。雷帕霉素(mTOR)抑制剂,如西罗莫司和依维莫司,也会改变脂质代谢。应鼓励生活方式和饮食的改变。仔细考虑免疫抑制剂的选择对于控制血脂异常也至关重要。他汀类药物被推荐作为降脂治疗的一线药物,需考虑潜在的药物相互作用。其他选择,如依折麦布和烟酸,也可以作为替代药物。肾移植患者血脂异常的管理主要涉及他汀类药物治疗,尽管该人群的临床疗效尚未得到充分证实。生活方式的改变、药物的谨慎选择和他汀类药物治疗是管理实体器官移植患者血脂异常的关键组成部分。