Second Line Options for Hyperlipidemia Management after Cardiac Transplantation

• Published in: Cardiovascular therapeutics Vol. 31; no. 3; pp. 138 - 146
• Main Authors: Shah, M.K.H., Critchley, W.R., Yonan, N., Williams, S.G., Shaw, S.M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2013; Blackwell; Hindawi Limited
• Subjects: Allograft vasculopathy; Azetidines - therapeutic use; Bezafibrate - therapeutic use; Biological and medical sciences; Cardiac transplant; Cardiovascular system; Cholesterol; Diet; Disorders of blood lipids. Hyperlipoproteinemia; Exercise; Ezetimibe; Fish Oils - therapeutic use; Heart Transplantation - adverse effects; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hyperlipidemia; Hyperlipidemias - therapy; Medical sciences; Metabolic diseases; Niacin - therapeutic use; Pharmacology. Drug treatments; Statins; Transplants & implants; Heart; Hyperlipidemia; Homograft; Metabolic diseases; Cardiovascular disease; Lipids; Statin derivative; Transplantation; Cholesterol; Vascular disease; Allograft vasculopathy; Hyperlipemia; Circulatory system; Dyslipemia; Cardiac transplant; Statins; Antilipemic agent
• ISSN: 1755-5914; 1755-5922
• DOI: 10.1111/j.1755-5922.2012.00315.x

Summary Despite widespread statin therapy, 91% of cardiac transplant patients have hyperlipidemia within 5 years from cardiac transplantation. The implications of this are profound, particularly given that coronary allograft vasculopathy is a leading cause of death. Unfortunately the solution is not easy, with problems of toleration at higher statin doses and a lack of good quality evidence for second line agents. We review the literature and discuss some of the key issues transplant physicians are faced with when considering alternatives to statin therapy.