Ten-Year Follow-Up of a Randomized Trial of Pravastatin in Heart Transplant Patients
| Autor: | Lawrence A. Yeatman, Greg Cogert, Hillel Laks, A. Marquez, Jon A. Kobashigawa, Antoine Hage, Maria Espejo Vassilakis, Jignesh Patel, Jaime Moriguchi, Liane Wener, Michele A. Hamilton |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Graft Rejection Male Pulmonary and Respiratory Medicine medicine.medical_specialty Randomization Coronary Disease Coronary Angiography law.invention chemistry.chemical_compound Randomized controlled trial law Internal medicine polycyclic compounds medicine Humans Transplantation Homologous Ultrasonography Interventional Survival analysis Pravastatin Transplantation Cholesterol business.industry Graft Survival Respiratory disease nutritional and metabolic diseases Middle Aged medicine.disease Survival Analysis Surgery Treatment Outcome chemistry Cardiology Heart Transplantation Female lipids (amino acids peptides and proteins) Transplant patient Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business Follow-Up Studies medicine.drug |
| Zdroj: | The Journal of Heart and Lung Transplantation. 24:1736-1740 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2005.02.009 |
| Popis: | Background Outcomes from this trial's first year data demonstrated significant benefit in heart transplant patients treated with pravastatin in cholesterol levels, survival, rejection with hemodynamic compromise, the development of cardiac allograft vasculopathy, and decreased natural killer cell cytotoxicity. Other heart transplant studies have shown similar benefit. We now report the 10-year follow-up of this study. Methods Ninety-seven heart transplant recipients were randomized to pravastatin ( n = 47) or no pravastatin ( n = 50) within 2 weeks after surgery both in combination with cyclosporine and corticosteroids. Ten-year outcomes include survival, cholesterol levels, and development of cardiac allograft vasculopathy documented by coronary angiography. Results Forty-two percent of the control patients crossed over to pravastatin treatment during the second year of the study, and 81% of the control patients were eventually placed on statin therapy by the 10-year follow-up. The control group had subsequent low and comparable cholesterol levels in Years 2 to10 of the study compared with the patients originally randomized to pravastatin. Intent-to-treat analysis demonstrated that the pravastatin group compared with control had increased 10-year survival (68% vs 48%, p = 0.026). The 10-year freedom from angiographic cardiac allograft vasculopathy and/or death in the pravastatin group was significantly greater compared with the control group (43% vs 20%, p = 0.009). Conclusion The 10-year follow-up of this study suggests that the use of pravastatin in heart transplant patients maintains survival benefit and appears to reduce the development of cardiac allograft vasculopathy. |
| Databáze: | OpenAIRE |
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