Impact of simvastatin therapy after heart transplantation an 11-year prospective evaluation.
OBJECTIVE
Prospective randomized trials have demonstrated that early and continuous use of statins in heart transplant recipients significantly decreases cholesterol and also significantly lowers mortality and the development of transplant vasculopathy. This evaluation presents the authors' 11-year experience using simvastatin in heart transplant patients.


METHODS
In 1991, a prospective randomized study was initiated comparing the efficacy of simvastatin, beginning on postoperative day 4 (n = 35), with that of a dietary therapy alone (n = 37) in heart transplant patients receiving standard triple immunosuppression. After 4 years most of the patients in both groups received statins due to a significantly improved survival and a lower incidence of transplant vasculopathy.


RESULTS
After 11 years Kaplan-Meier survival rates were 77% in the simvastatin group versus 56.8% in the control group (p < 0.05). The incidence of graft coronary vasculopathy confirmed by angiography was 34.6% in the simvastatin group versus 73.9% in the control group (p < 0.01). There was no difference in organ function between the two groups.


CONCLUSIONS
Statin therapy initiated in heart transplant patients early in the postoperative period plays an important role for better survival and lower incidence of transplant vasculopathy. The 11-year results of this study implicate that each heart transplant patient should receive early treatment with a statin as a matter of routine.
Wenke
Klaus
K
Division of Cardiac Surgery, Hospital Munich-Bogenhausen, Munich-Bogenhausen, Germany. klaus.wenke@extern.lrz-muenchen.de
Meiser
Bruno
B
Thiery
Joachim
J
Reichart
Bruno
B
D000924:Anticholesteremic Agents / Q000627:therapeutic use; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000401:mortality* / Q000517:prevention & control*; D004035:Diet Therapy / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D006084:Graft Rejection / Q000401:mortality* / Q000517:prevention & control*; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D008137:Longitudinal Studies; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D019821:Simvastatin / Q000627:therapeutic use*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
D000924:Anticholesteremic Agents; D019821:Simvastatin