title: Clinical evaluation of rosuvastatin in heart transplant patients with hypercholesterolemia and therapeutic failure of other statin regimens: short-term and long-term efficacy and safety results.
abstract: We conducted an observational study of 30 heart transplant recipients with serum low-density lipoprotein cholesterol (LDL-c) >100 mg/dl despite previous statin therapy, who were treated with rosuvastatin 10 mg daily (5 mg in case of renal dysfunction). Serum lipids, creatine phosphokinase (CPK), bilirubin, and hepatic enzymes were prospectively measured 2, 4, and 12 weeks after the initiation of the drug. Clinical outcomes of patients who continued on long-term rosuvastatin therapy beyond this 12-week period were reviewed in February 2015. Over the 12-week period following rosuvastatin initiation, serum levels of total cholesterol (TC) and LDL-c and the ratio TC/high-density lipoprotein cholesterol (HDL-c) decreased steadily (P < 0.001). Average absolute reductions of these three parameters were -48.7 mg/dl, -46.6 mg/dl, and -0.9, respectively. Seventeen (57%) achieved a serum LDL-c < 100 mg/dl. No significant changes from baseline were observed in serum levels of triglycerides, HDL-c, hepatic enzymes, bilirubin, or CPK. Twenty-seven (90%) patients continued on long-term therapy with rosuvastatin over a median period of 3.6 years, with no further significant variation in lipid profile. The drug was suspended due to liver toxicity in 1 (3.3%) patient and due to muscle toxicity in 2 (6.7%) patients. All adverse reactions resolved rapidly after rosuvastatin withdrawal. Our study supports rosuvastatin as a reasonable alternative for heart transplant recipients with hypercholesterolemia and therapeutic failure of other statin regimens.
authors: Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.|Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.
authors: Gonzalo
authors: http://orcid.org/0000-0001-5662-5323
authors: G
authors: Barge-Caballero
authors: Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.|Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.
authors: Eduardo
authors: E
authors: Barge-Caballero
authors: Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.|Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.
authors: Raquel
authors: R
authors: Marzoa-Rivas
authors: Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.|Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.
authors: María J
authors: MJ
authors: Paniagua-Martín
authors: Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.|Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.
authors: Alfredo
authors: A
authors: Barrio-Rodríguez
authors: Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.|Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.
authors: Carmen
authors: C
authors: Naya-Leira
authors: Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.|Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.
authors: Paula
authors: P
authors: Blanco-Canosa
authors: Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.|Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.
authors: Zulaika
authors: Z
authors: Grille-Cancela
authors: Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.|Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.
authors: José Manuel
authors: JM
authors: Vázquez-Rodríguez
authors: Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.|Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.
authors: María G
authors: MG
authors: Crespo-Leiro
mesh_terms: D000368:Aged; D001663:Bilirubin / Q000097:blood; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000601:surgery; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008099:Liver / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D011446:Prospective Studies; D012189:Retrospective Studies; D000068718:Rosuvastatin Calcium / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents; D000068718:Rosuvastatin Calcium; D002784:Cholesterol; D003402:Creatine Kinase; D001663:Bilirubin
keywords: heart transplantation; hypercholesterolemia; rosuvastatin