Lipid abnormalities after cardiac transplantation
- Howard J Eisen, MD
Howard J Eisen, MD
- Thomas J Vischer Professor of Medicine
- Drexel University College of Medicine
- Section Editors
- Sharon A Hunt, MD
Sharon A Hunt, MD
- Editor-in-Chief — Cardiovascular Medicine
- Section Editor — Heart Transplantation
- Professor of Medicine
- Stanford University School of Medicine
- Mason W Freeman, MD
Mason W Freeman, MD
- Section Editor — Lipids
- Professor of Medicine
- Harvard Medical School
Hyperlipidemia occurs in 60 to 83 percent of heart transplant recipients treated with modern, conventional immunosuppressive therapy [1-6]. The abnormalities that occur include elevations in the serum levels of total and low density lipoprotein (LDL) cholesterol and in serum triglycerides (TG).
The magnitude of these effects was illustrated in a study of 100 heart transplant recipients who survived more than three months after surgery . The following differences were noted between the baseline and three month values; there were no significant further increases over time:
●Total cholesterol – 168 to 234 mg/dL (4.4 to 6.1 mmol/L)
●LDL cholesterol – 111 to 148 mg/dL (2.9 to 3.8 mmol/L)
●High density lipoprotein (HDL) cholesterol – 34 to 47 mg/dL (0.9 to 1.2 mmol/L)
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- ETIOLOGY OF HYPERLIPIDEMIA
- Calcineurin inhibitors
- RATIONALE FOR THERAPY
- APPROACH TO THERAPY
- General approach
- - Clinical trials
- - Side effects and drug interactions
- Fibric acid derivatives
- - Nicotinic acid
- - Bile acid sequestrants
- - Ezetimibe
- - LDL apheresis
- - PCSK9 inhibitors
- Goal LDL cholesterol
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS