Xinyi Huang, Melana Yuzefpolskaya, Paolo C. Colombo, Jason Choe, Tara Shertel, Douglas L. Jennings
{"title":"他汀类药物强度对心脏移植血管病早期进展的影响","authors":"Xinyi Huang, Melana Yuzefpolskaya, Paolo C. Colombo, Jason Choe, Tara Shertel, Douglas L. Jennings","doi":"10.1111/ctr.70030","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Limited research has compared the relative risks and benefits different statins have after heart transplantation (HT).</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>We hypothesize that higher statin intensity is associated with a smaller degree of allograft intimal thickening on intravascular ultrasound (IVUS) at 1-year post-HT. Allograft intima-media thickness (IMT) on the first annual IVUS was retrospectively compared in patients initiated on a low-intensity statin (pravastatin 20 mg daily) versus moderate-intensity statin (atorvastatin 20 mg daily) post-HT.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 172 adult patients were included (2018–2022, <i>n</i> = 86 in each group). At 1 year, the maximal IMT was lower in the moderate-intensity statin group, but the difference did not reach statistical significance. The LDL levels at 1 year trended lower with moderate-intensity statin therapy, while the rates of adverse reactions were not statistically different. A multivariate analysis of the logistic regression model showed moderate statin intensity at 12 months was protective, while donor-specific antibodies developed within the first-year posttransplant were associated with IMT ≥ 0.5 mm on the first annual IVUS.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This study found that using moderate-intensity statin to prevent the early progression was as safe and possibly more effective than low-intensity statin therapy for the prevention of early cardiac allograft vasculopathy.</p>\n </section>\n </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"38 11","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Impact of Statin Intensity on the Early Progression of Cardiac Allograft Vasculopathy\",\"authors\":\"Xinyi Huang, Melana Yuzefpolskaya, Paolo C. Colombo, Jason Choe, Tara Shertel, Douglas L. Jennings\",\"doi\":\"10.1111/ctr.70030\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Limited research has compared the relative risks and benefits different statins have after heart transplantation (HT).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Method</h3>\\n \\n <p>We hypothesize that higher statin intensity is associated with a smaller degree of allograft intimal thickening on intravascular ultrasound (IVUS) at 1-year post-HT. Allograft intima-media thickness (IMT) on the first annual IVUS was retrospectively compared in patients initiated on a low-intensity statin (pravastatin 20 mg daily) versus moderate-intensity statin (atorvastatin 20 mg daily) post-HT.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 172 adult patients were included (2018–2022, <i>n</i> = 86 in each group). At 1 year, the maximal IMT was lower in the moderate-intensity statin group, but the difference did not reach statistical significance. The LDL levels at 1 year trended lower with moderate-intensity statin therapy, while the rates of adverse reactions were not statistically different. 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The Impact of Statin Intensity on the Early Progression of Cardiac Allograft Vasculopathy
Background
Limited research has compared the relative risks and benefits different statins have after heart transplantation (HT).
Method
We hypothesize that higher statin intensity is associated with a smaller degree of allograft intimal thickening on intravascular ultrasound (IVUS) at 1-year post-HT. Allograft intima-media thickness (IMT) on the first annual IVUS was retrospectively compared in patients initiated on a low-intensity statin (pravastatin 20 mg daily) versus moderate-intensity statin (atorvastatin 20 mg daily) post-HT.
Results
A total of 172 adult patients were included (2018–2022, n = 86 in each group). At 1 year, the maximal IMT was lower in the moderate-intensity statin group, but the difference did not reach statistical significance. The LDL levels at 1 year trended lower with moderate-intensity statin therapy, while the rates of adverse reactions were not statistically different. A multivariate analysis of the logistic regression model showed moderate statin intensity at 12 months was protective, while donor-specific antibodies developed within the first-year posttransplant were associated with IMT ≥ 0.5 mm on the first annual IVUS.
Conclusion
This study found that using moderate-intensity statin to prevent the early progression was as safe and possibly more effective than low-intensity statin therapy for the prevention of early cardiac allograft vasculopathy.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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