Hypercholesterolemia is common after pediatric heart transplantation: Initial experience with pravastatin

Ingrid M. Seipelt, Susan E. Crawford, Sherrie Rodgers, Carl Backer, Constantine Mavroudis, Ralf G. Seipelt, Elfriede Pahl

Research output: Contribution to journalReview article

Abstract

Background Coronary allograft vasculopathy (CAV) is a progressive complication after cardiac transplantation and limits survival. Hyperlipidemia is a known risk factor for CAV, and pravastatin is effective in decreasing cholesterol levels in adults after transplantation. However, few data exist regarding lipid profiles and statin use after pediatric heart transplantation. We evaluated the prevalence of hyperlipidemia in pediatric heart transplant recipients and assessed the efficacy and safety of pravastatin therapy. Methods We performed a retrospective chart review of lipid profiles ≥1 year after surgery in 50 pediatric cardiac transplant recipients to assess the incidence of hyperlipidemia. Twenty of these patients received pravastatin for hypercholesterolemia. Their primary immunosuppression therapy was cyclosporine/prednisone plus either azathioprine or mycophenolate mofetil. We reviewed serial lipid profiles, creatinine phosphokinase, and liver enzymes. Results Overall, 36% of the patients (n = 50) had total cholesterol (TC) concentrations > 200 mg/dl and 52% had low-density lipoprotein (LDL) >110 mg/dL beyond 1 year after transplantation. Of the 20 treated with pravastatin, TC (236 ± 51 vs 174 ± 33 mg/dl) and LDL levels (151 ± 32 vs 99 ± 21 mg/dl) decreased significantly with therapy (p < .0001). We found no symptoms; however, 1 patient had increased creatinine phosphokinase. Liver enzyme concentrations remained normal in all. Conclusions Hypercholesterolemia is prevalent in pediatric cardiac transplant recipients. Pravastatin therapy is effective in decreasing TC and LDL levels, seems to be safe, and is tolerated well. Further studies are necessary to determine whether pravastatin treatment is beneficial in decreasing CAV.

Original languageEnglish (US)
Pages (from-to)317-322
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume23
Issue number3
DOIs
StatePublished - Mar 1 2004
Externally publishedYes

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Pravastatin
Heart Transplantation
Hypercholesterolemia
Pediatrics
Hyperlipidemias
Allografts
Cholesterol
Lipids
LDL Lipoproteins
Creatinine
Phosphotransferases
Transplantation
Mycophenolic Acid
Therapeutics
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Liver
Azathioprine
Enzymes
Prednisone
LDL Cholesterol

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Cite this

Hypercholesterolemia is common after pediatric heart transplantation : Initial experience with pravastatin. / Seipelt, Ingrid M.; Crawford, Susan E.; Rodgers, Sherrie; Backer, Carl; Mavroudis, Constantine; Seipelt, Ralf G.; Pahl, Elfriede.

In: Journal of Heart and Lung Transplantation, Vol. 23, No. 3, 01.03.2004, p. 317-322.

Research output: Contribution to journalReview article

Seipelt, Ingrid M. ; Crawford, Susan E. ; Rodgers, Sherrie ; Backer, Carl ; Mavroudis, Constantine ; Seipelt, Ralf G. ; Pahl, Elfriede. / Hypercholesterolemia is common after pediatric heart transplantation : Initial experience with pravastatin. In: Journal of Heart and Lung Transplantation. 2004 ; Vol. 23, No. 3. pp. 317-322.
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abstract = "Background Coronary allograft vasculopathy (CAV) is a progressive complication after cardiac transplantation and limits survival. Hyperlipidemia is a known risk factor for CAV, and pravastatin is effective in decreasing cholesterol levels in adults after transplantation. However, few data exist regarding lipid profiles and statin use after pediatric heart transplantation. We evaluated the prevalence of hyperlipidemia in pediatric heart transplant recipients and assessed the efficacy and safety of pravastatin therapy. Methods We performed a retrospective chart review of lipid profiles ≥1 year after surgery in 50 pediatric cardiac transplant recipients to assess the incidence of hyperlipidemia. Twenty of these patients received pravastatin for hypercholesterolemia. Their primary immunosuppression therapy was cyclosporine/prednisone plus either azathioprine or mycophenolate mofetil. We reviewed serial lipid profiles, creatinine phosphokinase, and liver enzymes. Results Overall, 36{\%} of the patients (n = 50) had total cholesterol (TC) concentrations > 200 mg/dl and 52{\%} had low-density lipoprotein (LDL) >110 mg/dL beyond 1 year after transplantation. Of the 20 treated with pravastatin, TC (236 ± 51 vs 174 ± 33 mg/dl) and LDL levels (151 ± 32 vs 99 ± 21 mg/dl) decreased significantly with therapy (p < .0001). We found no symptoms; however, 1 patient had increased creatinine phosphokinase. Liver enzyme concentrations remained normal in all. Conclusions Hypercholesterolemia is prevalent in pediatric cardiac transplant recipients. Pravastatin therapy is effective in decreasing TC and LDL levels, seems to be safe, and is tolerated well. Further studies are necessary to determine whether pravastatin treatment is beneficial in decreasing CAV.",
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T2 - Initial experience with pravastatin

AU - Seipelt, Ingrid M.

AU - Crawford, Susan E.

AU - Rodgers, Sherrie

AU - Backer, Carl

AU - Mavroudis, Constantine

AU - Seipelt, Ralf G.

AU - Pahl, Elfriede

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N2 - Background Coronary allograft vasculopathy (CAV) is a progressive complication after cardiac transplantation and limits survival. Hyperlipidemia is a known risk factor for CAV, and pravastatin is effective in decreasing cholesterol levels in adults after transplantation. However, few data exist regarding lipid profiles and statin use after pediatric heart transplantation. We evaluated the prevalence of hyperlipidemia in pediatric heart transplant recipients and assessed the efficacy and safety of pravastatin therapy. Methods We performed a retrospective chart review of lipid profiles ≥1 year after surgery in 50 pediatric cardiac transplant recipients to assess the incidence of hyperlipidemia. Twenty of these patients received pravastatin for hypercholesterolemia. Their primary immunosuppression therapy was cyclosporine/prednisone plus either azathioprine or mycophenolate mofetil. We reviewed serial lipid profiles, creatinine phosphokinase, and liver enzymes. Results Overall, 36% of the patients (n = 50) had total cholesterol (TC) concentrations > 200 mg/dl and 52% had low-density lipoprotein (LDL) >110 mg/dL beyond 1 year after transplantation. Of the 20 treated with pravastatin, TC (236 ± 51 vs 174 ± 33 mg/dl) and LDL levels (151 ± 32 vs 99 ± 21 mg/dl) decreased significantly with therapy (p < .0001). We found no symptoms; however, 1 patient had increased creatinine phosphokinase. Liver enzyme concentrations remained normal in all. Conclusions Hypercholesterolemia is prevalent in pediatric cardiac transplant recipients. Pravastatin therapy is effective in decreasing TC and LDL levels, seems to be safe, and is tolerated well. Further studies are necessary to determine whether pravastatin treatment is beneficial in decreasing CAV.

AB - Background Coronary allograft vasculopathy (CAV) is a progressive complication after cardiac transplantation and limits survival. Hyperlipidemia is a known risk factor for CAV, and pravastatin is effective in decreasing cholesterol levels in adults after transplantation. However, few data exist regarding lipid profiles and statin use after pediatric heart transplantation. We evaluated the prevalence of hyperlipidemia in pediatric heart transplant recipients and assessed the efficacy and safety of pravastatin therapy. Methods We performed a retrospective chart review of lipid profiles ≥1 year after surgery in 50 pediatric cardiac transplant recipients to assess the incidence of hyperlipidemia. Twenty of these patients received pravastatin for hypercholesterolemia. Their primary immunosuppression therapy was cyclosporine/prednisone plus either azathioprine or mycophenolate mofetil. We reviewed serial lipid profiles, creatinine phosphokinase, and liver enzymes. Results Overall, 36% of the patients (n = 50) had total cholesterol (TC) concentrations > 200 mg/dl and 52% had low-density lipoprotein (LDL) >110 mg/dL beyond 1 year after transplantation. Of the 20 treated with pravastatin, TC (236 ± 51 vs 174 ± 33 mg/dl) and LDL levels (151 ± 32 vs 99 ± 21 mg/dl) decreased significantly with therapy (p < .0001). We found no symptoms; however, 1 patient had increased creatinine phosphokinase. Liver enzyme concentrations remained normal in all. Conclusions Hypercholesterolemia is prevalent in pediatric cardiac transplant recipients. Pravastatin therapy is effective in decreasing TC and LDL levels, seems to be safe, and is tolerated well. Further studies are necessary to determine whether pravastatin treatment is beneficial in decreasing CAV.

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