Retrospective analysis of hyperlipidemia management in a transplant population.
OBJECTIVE
To determine the prevalence of hyperlipidemia and the effectiveness of hyperlipidemia management in a large population of transplant recipients. A secondary objective was to assess the effect of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III guidelines on hyperlipidemia management compared with the effect from earlier guidelines.


METHODS
Retrospective review of computerized records.


METHODS
University-affiliated transplantation center.


METHODS
Three thousand four hundred fourteen patients with liver, kidney, or pancreas transplants.


RESULTS
To determine a diagnosis of hyperlipidemia and the effectiveness of treatment, we assessed the patients's lipid levels. Hyperlipidemia was defined as a total cholesterol level above 200 mg/dl and/or the use of antihyperlipidemic drugs. Of the 3414 patients in the study, 1638 (48%) had hyperlipidemia. Of these, 711 (43%) were receiving antihyperlipidemic drugs; 227 (32%) of the 711 patients had achieved the total cholesterol goal of 200 mg/dl or below. Low-density lipoprotein cholesterol (LDL) levels were available for 1953 (57%) patients. Of these, 537 patients were receiving cholesterol-lowering drugs, and 384 (72%) of the 537 patients achieved the LDL goal of less than 130 mg/dl.


CONCLUSIONS
Although NCEP guidelines recommend monitoring LDL, only slightly more than half of these transplant recipients were monitored. In addition, the patients identified as having hyperlipidemia were not effectively treated to lower their cholesterol levels. Clinicians must be aggressive in diagnosing, monitoring, and treating hyperlipidemia to decrease the rate of cardiovascular disease and to prolong patient survival after transplantation.
Schonder
Kristine S
KS
Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania 15213, USA. schonderks@msx.upmc.edu
McKaveney
Teresa P
TP
Lynch
Kevin J
KJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D005260:Female; D019983:Guideline Adherence; D006785:Hospitals, University; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000453:epidemiology; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
D000960:Hypolipidemic Agents; D002784:Cholesterol