Cardiology Letters 2012, 21(6):469-473

Rosuvastatin has therapeutic potential in patients after heart transplantation.

Luknar M¹, Lesny P¹, Varga I¹, Solik P¹, Kucerova D¹, Danova K²

¹ Heart Failure and Transplant Department

² Department of Laboratory Medicine, National Cardiovascular Institute, Bratislava, Slovakia

Background: Heart transplant (HTx) recipients are at high cardiovascular risk and strict risk factor control is warranted. Hypercholesterolemia is frequent after HTx and statins are routinely administered. Statins, however, are linked to a substantial risk of harmful side effects. Rosuvastatin has been proven effective and safe in the general population. Data on rosuvastatin use in HTx recipients are scarce. We evaluated the safety of rosuvastatin and its influence on blood lipids in patients after HTx.

Patients and methods: Sixteen HTx recipients with inadequate hypolipidemic response to fluvastatin 80 mg (median age 57 (36-60) years, 11 men) were evaluated. All patients received a combined immunosuppressive regimen. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triacylglycerole (TAG) levels were determined at initial evaluation. Subsequently, open-label rosuvastatin 10 mg/day was initiated and fluvastatin was stopped. After a median 12 (4-24) weeks, the same parameters were measured. Clinical adverse events were reported and blood levels of creatine phosphokinase, myoglobin, and aminotransferases were determined. Differences between baseline and onrosuvastatin lipid levels were assessed by Wilcoxon paired test.

Results: After rosuvastatin use, TC decreased from 6.22±0.70 mmol/L to 5.45±0.88 mmol/L (p<0.05). LDL cholesterol dropped from 3.69±0.76 mmol/L to 2.93±0.76 mmol/L (p=0.02). Increase in HDL-C and decrease in TAG levels were not statistically significant. Only 2 patients reached TC levels <4.5 mmol/L and 4 reached LDL values <2.5 mmol/L. No serious clinical and laboratory adverse effects or significant change in immunosuppressant level were recorded.

Conclusion: Rosuvastatin 10 mg was safe and effective in HTx recipients with sub-optimal lipid levels on their previous statin treatment. However, reaching targets recommended for high-risk populations probably requires higher doses. Determination of long-term safety and efficacy of such doses, and their influence on morbidity and mortality, warrants further study.

Keywords: rosuvastatin; heart transplantation; statins; hypercholesterolemia; hypolipidemic treatment

Published: June 1, 2012  Show citation