The Impact of Statin Intensity on the Early Progression of Cardiac Allograft Vasculopathy.

Publisher: Munksgaard Country of Publication: Denmark NLM ID: 8710240 Publication Model: Print Cited Medium: Internet ISSN: 1399-0012 (Electronic) Linking ISSN: 09020063 NLM ISO Abbreviation: Clin Transplant Subsets: MEDLINE

Original Publication: Copenhagen : Munksgaard,

Heart Transplantation*/adverse effects ; Hydroxymethylglutaryl-CoA Reductase Inhibitors*/therapeutic use ; Allografts* ; Disease Progression*; Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Follow-Up Studies ; Prognosis ; Risk Factors ; Graft Rejection/etiology ; Graft Rejection/pathology ; Graft Rejection/prevention & control ; Graft Rejection/drug therapy ; Postoperative Complications/prevention & control ; Adult ; Carotid Intima-Media Thickness ; Graft Survival/drug effects ; Ultrasonography, Interventional ; Coronary Artery Disease/etiology ; Coronary Artery Disease/pathology

Background: Limited research has compared the relative risks and benefits different statins have after heart transplantation (HT).
Method: We hypothesize that higher statin intensity is associated with a smaller degree of allograft intimal thickening on intravascular ultrasound (IVUS) at 1-year post-HT. Allograft intima-media thickness (IMT) on the first annual IVUS was retrospectively compared in patients initiated on a low-intensity statin (pravastatin 20 mg daily) versus moderate-intensity statin (atorvastatin 20 mg daily) post-HT.
Results: A total of 172 adult patients were included (2018-2022, n = 86 in each group). At 1 year, the maximal IMT was lower in the moderate-intensity statin group, but the difference did not reach statistical significance. The LDL levels at 1 year trended lower with moderate-intensity statin therapy, while the rates of adverse reactions were not statistically different. A multivariate analysis of the logistic regression model showed moderate statin intensity at 12 months was protective, while donor-specific antibodies developed within the first-year posttransplant were associated with IMT ≥ 0.5 mm on the first annual IVUS.
Conclusion: This study found that using moderate-intensity statin to prevent the early progression was as safe and possibly more effective than low-intensity statin therapy for the prevention of early cardiac allograft vasculopathy.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

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Keywords: cardiac allograft vasculopathy; heart transplantation; statins

0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)

Date Created: 20241119 Date Completed: 20241119 Latest Revision: 20241119

20241120

10.1111/ctr.70030

39558563