title: Comparison of the effectiveness of lovastatin therapy for hypercholesterolemia after heart transplantation between patients with and without pretransplant atherosclerotic coronary artery disease.
abstract: With the aim of assessing the effectiveness and safety of lovastatin in patients with hypercholesterolemia after heart transplantation, as well as the potential differences in the lipid-lowering effect of lovastatin between patients with or without pretransplant coronary artery disease (CAD), we studied 63 heart transplant patients who had serum total cholesterol > 250 mg/dl in spite of dietary therapy. Mean age of subjects was 47 +/- 2 years. Triple-drug immunosuppressive therapy consisted of cyclosporine, azathioprine, and steroids. Thirty-nine patients (62%) had pretransplant CAD and 24 (38%) did not. Pretreatment serum lipid levels were: total cholesterol, 302 +/- 32 mg/dl; low-density lipoprotein (LDL) cholesterol, 201 +/- 35 mg/dl; high-density lipoprotein (HDL) cholesterol, 60 +/- 19 mg/dl; triglycerides, 205 +/- 86 mg/dl; and total/HDL cholesterol ratio, 5.4 +/- 1.6. Patients received 10 to 40 mg/day of lovastatin (mean dose 17 +/- 6) for 13 +/- 4 months. There were no serious adverse events. At 3 months, lovastatin decreased total cholesterol by 15% (p < 0.001), LDL cholesterol by 21% (p < 0.001), triglycerides by 17% (p < 0.05), and total/HDL cholesterol ratio by 17% (p < 0.001), and increased HDL cholesterol by 3% (NS). Although lovastatin was effective in both patients with pretransplant CAD and non-CAD, analysis of its effect in each subgroup (CAD and non-CAD) revealed that its lipid-lowering effect was higher for non-CAD patients (-20% vs -12% for total cholesterol, and -27% vs -17% for LDL cholesterol, both p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Cardiology, Hospital Reina Sofía, Córdoba, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Anguita
authors.forename: L
authors.initials: L
authors.lastname: Alonso-Pulpón
authors.forename: J M
authors.initials: JM
authors.lastname: Arizón
authors.forename: M A
authors.initials: MA
authors.lastname: Cavero
authors.forename: F
authors.initials: F
authors.lastname: Vallés
authors.forename: J
authors.initials: J
authors.lastname: Segovia
authors.forename: F
authors.initials: F
authors.lastname: Pérez-Jiménez
authors.forename: M
authors.initials: M
authors.lastname: Crespo
authors.forename: M
authors.initials: M
authors.lastname: Concha
mesh_terms: D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000150:complications*; D005260:Female; D016027:Heart Transplantation / Q000502:physiology; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy* / Q000209:etiology; D008148:Lovastatin / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D002784:Cholesterol; D008148:Lovastatin