Effect of Statin Intensity on the Progression of Cardiac Allograft Vasculopathy
Background: In the non-transplant population, hyperlipidaemia has shifted from targeting LDL goals to statin intensity-based treatment. It is unknown whether this strategy is also beneficial in cardiac transplantation. Methods: This single-centre retrospective study evaluated the effect of statin us...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Radcliffe Medical Media
2021-11-01
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| Series: | Cardiac Failure Review |
| Online Access: | https://www.cfrjournal.com/articleindex/cfr.2021.07 |
| _version_ | 1797200023963828224 |
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| author | Tracey M Ellimuttil Kimberly Harrison Allman T Rollins Irene D Feurer Scott A Rega Jennifer Gray Jonathan N Menachem |
| author_facet | Tracey M Ellimuttil Kimberly Harrison Allman T Rollins Irene D Feurer Scott A Rega Jennifer Gray Jonathan N Menachem |
| author_sort | Tracey M Ellimuttil |
| collection | DOAJ |
| description | Background: In the non-transplant population, hyperlipidaemia has shifted from targeting LDL goals to statin intensity-based treatment. It is unknown whether this strategy is also beneficial in cardiac transplantation. Methods: This single-centre retrospective study evaluated the effect of statin use and intensity on time to cardiac allograft vasculopathy (CAV) after cardiac transplantation. Kaplan–Meier and Cox proportional hazards regression survival methods were used to assess the association of statin intensity and median post-transplant LDL on CAV-free survival. Results: The study involved 143 adults (71% men, average follow-up of 25 ± 14 months) who underwent transplant between 2013 and 2017. Mean CAV-free survival was 47.5 months (95% CI [43.1–51.8]), with 29 patients having CAV grade 1 or greater. Median LDL was not associated with time to CAV (p=0.790). CAV-free survival did not differ between intensity groups (p=0.435). Conclusion: Given the non-statistically significant difference in time to CAV with higher intensity statins, the data suggest that advancing moderate- or high-intensity statin after cardiac transplantation may not provide additional long-term clinical benefit. Trial registration: Not applicable. |
| first_indexed | 2024-03-07T17:40:33Z |
| format | Article |
| id | doaj.art-06f56a7e51da4736ba2419a7a39ea90c |
| institution | Directory Open Access Journal |
| issn | 2057-7540 2057-7559 |
| language | English |
| last_indexed | 2024-04-24T07:25:04Z |
| publishDate | 2021-11-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | Cardiac Failure Review |
| spelling | doaj.art-06f56a7e51da4736ba2419a7a39ea90c2024-04-20T16:02:28ZengRadcliffe Medical MediaCardiac Failure Review2057-75402057-75592021-11-01710.15420/cfr.2021.07Effect of Statin Intensity on the Progression of Cardiac Allograft VasculopathyTracey M Ellimuttil0Kimberly Harrison1Allman T Rollins2Irene D Feurer3Scott A Rega4Jennifer Gray5Jonathan N Menachem6Department of Pharmacy, Vanderbilt University Medical Center, Nashville, TN, USDepartment of Pharmacy, Vanderbilt University Medical Center, Nashville, TN, US; Vanderbilt Transplant Center, Nashville, TN, USVanderbilt Transplant Center, Nashville, TN, US; Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USVanderbilt Transplant Center, Nashville, TN, US; Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, US; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USVanderbilt Transplant Center, Nashville, TN, USDepartment of Pharmacy, Vanderbilt University Medical Center, Nashville, TN, US; Vanderbilt Transplant Center, Nashville, TN, USVanderbilt Transplant Center, Nashville, TN, US; Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USBackground: In the non-transplant population, hyperlipidaemia has shifted from targeting LDL goals to statin intensity-based treatment. It is unknown whether this strategy is also beneficial in cardiac transplantation. Methods: This single-centre retrospective study evaluated the effect of statin use and intensity on time to cardiac allograft vasculopathy (CAV) after cardiac transplantation. Kaplan–Meier and Cox proportional hazards regression survival methods were used to assess the association of statin intensity and median post-transplant LDL on CAV-free survival. Results: The study involved 143 adults (71% men, average follow-up of 25 ± 14 months) who underwent transplant between 2013 and 2017. Mean CAV-free survival was 47.5 months (95% CI [43.1–51.8]), with 29 patients having CAV grade 1 or greater. Median LDL was not associated with time to CAV (p=0.790). CAV-free survival did not differ between intensity groups (p=0.435). Conclusion: Given the non-statistically significant difference in time to CAV with higher intensity statins, the data suggest that advancing moderate- or high-intensity statin after cardiac transplantation may not provide additional long-term clinical benefit. Trial registration: Not applicable.https://www.cfrjournal.com/articleindex/cfr.2021.07 |
| spellingShingle | Tracey M Ellimuttil Kimberly Harrison Allman T Rollins Irene D Feurer Scott A Rega Jennifer Gray Jonathan N Menachem Effect of Statin Intensity on the Progression of Cardiac Allograft Vasculopathy Cardiac Failure Review |
| title | Effect of Statin Intensity on the Progression of Cardiac Allograft Vasculopathy |
| title_full | Effect of Statin Intensity on the Progression of Cardiac Allograft Vasculopathy |
| title_fullStr | Effect of Statin Intensity on the Progression of Cardiac Allograft Vasculopathy |
| title_full_unstemmed | Effect of Statin Intensity on the Progression of Cardiac Allograft Vasculopathy |
| title_short | Effect of Statin Intensity on the Progression of Cardiac Allograft Vasculopathy |
| title_sort | effect of statin intensity on the progression of cardiac allograft vasculopathy |
| url | https://www.cfrjournal.com/articleindex/cfr.2021.07 |
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