Survival, graft atherosclerosis, and rejection incidence in heart transplant recipients treated with statins: 5-year follow-up.
BACKGROUND
Few studies have examined the long-term benefits of statin treatment in heart transplant recipients.


METHODS
In this observational study, we retrospectively reviewed data pertaining to 5-year follow-up of patients who underwent heart transplantation between 1993 and 1996 and who survived the first 30 days after transplantation. Patients were assigned to groups according to whether or not they received pravastatin after transplantation, and then compared with regard to transplant rejection, transplant coronary artery disease, and survival.


RESULTS
Ninety-one patients received pravastatin after transplantation, whereas 37 did not receive any statins and served as controls. Pravastatin did not affect the overall incidence of rejections or number of rejection episodes. Hemodynamically significant rejection episodes occurred in 5 patients (5%) in the pravastatin group and 4 patients (11%) in the control group. Thus, pravastatin treatment apparently reduced the incidence of hemodynamically significant rejection episodes by 50% (p = 0.04). Transplant coronary artery disease (CAD) occurred in 10 patients (11%) in the pravastatin group and 9 patients (24%) in the control group. Treatment with pravastatin significantly reduced the incidence of transplant CAD (p = 0.05). Three- and 5-year survival rates in the pravastatin group were significantly better than in the control group (87% vs 68% and 82% vs 58%, respectively; p = 0.009).


CONCLUSIONS
Pravastatin therapy offers long-term benefits to heart transplant recipients. It improves 5-year survival, lowers the risk of transplant CAD, and lowers the incidence of hemodynamically significant rejection episodes.
Stojanovic
Ivan
I
Cardiopulmonary Transplantation Service, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA.
Vrtovec
Bojan
B
Radovancevic
Branislav
B
Radovancevic
Rajko
R
Yazdanbakhsh
Aria P
AP
Thomas
Cynthia D
CD
Frazier
O H
OH
D000293:Adolescent; D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D016027:Heart Transplantation / Q000401:mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000627:therapeutic use*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents; D017035:Pravastatin