Role of Statins on Cardiac Allograft Vasculopathy Prevention in Post Heart Transplant Patients
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Abstract
Heart replacement or heart transplantation is a treatment for end-stage heart failure patients unresponsive to other alternative therapies. The operation brings the donor's heart to replace the patient's heart at original position. Major complication of heart transplants is organ rejection. One of the causes is cardiac allograft vasculopathy (CAV), a condition in which endothelium of the vessels in the transplanted heart becomes thickened. This can be found in 33% and 50% of patients after 5 years and after 10 years of heart transplant. CAV can be prevented with statins. The International Society of Heart and Lung Transplantation in 2010 recommended that statins be started within 2 weeks after heart transplant to prevent CAV. In addition, the use of statins in heart transplant patients has a clear benefit in reducing mortality rate, organ rejection, and abnormality of heart vessels. The drugs with most clinical evidences were simvastatin and pravastatin. Doses of the drugs depend on the possibility of their interaction with immune-suppressants and patients’ renal function. Therefore, a low dose should be given to prevent muscle-related adverse reactions. According to a recent study in heart transplant patients, high-intensity statin significantly reduced hospital readmissions from CAV-related heart failure and mortality than low to moderate-intensity statin group did. Therefore, statins not only lower lipid levels and prevent cardiovascular disease, but also increase the survival rate and reduce severe complications in heart transplant patients.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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