Treatment of hyperlipidemia in heart transplant recipients with gemfibrozil ± lovastatin

Peters, Jeffrey R.; Kubo, Spencer H.; Olivari, Maria Teresa; Knutson, Kevin R.; Hunninghake, Donald B.

doi:10.1016/0002-9149(93)90624-l

Cited by 16 publications

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11 The title of the last article that was excluded was misleading because no combination therapy was given. 63 The remaining 36 articles were published between 1988 and 2000 (Table 3). 11,18,31,64-96 Twenty-one of the trials were open-label, six were retrospective, and 10 were prospective studies.…”

Section: Clinical Trialsmentioning

confidence: 99%

Statin—Fibrate Combination Therapy

2001

View full text Add to dashboard Cite

Combination therapy with a statin and fibrate offers significant therapeutic advantage for the treatment of severe or refractory mixed hyperlipidemia. Although such a combination does increase the risk of myopathy, with an incidence of approximately 0.12%, this small risk of myopathy rarely outweighs the established morbidity and mortality benefits of achieving lipid goals. Nevertheless, a higher incidence of myopathy has been reported with statin monotherapy. When monotherapy with a statin fails to control mixed hyperlipidemia, combination therapy may be considered. Niacin may be added before a fibrate is considered, as it appears to have less risk of myopathy. Statin-fibrate combination therapy must be undertaken cautiously and only after careful risk-benefit analysis. Patient counseling on the risks and warning signs of myopathy is extremely important.

show abstract

Section: Clinical Trialsmentioning

confidence: 99%

Statin—Fibrate Combination Therapy

2001

View full text Add to dashboard Cite

show abstract

“…Therefore, besides the continuous improvement of immunosuppressive therapy (ATG, OKT‐3, FK‐506, etc. ), researchers are trying to remove the factors that can contribute to the progressive development of coronary atherosclerosis ( 14). We hope that the adaptation of plasmapheresis in the treatment of patients with transplantation of the heart will help us in the solution of this problem.…”

Section: Discussionmentioning

confidence: 99%

Plasmapheresis in the Treatment of Posttransplant Cardiomyopathy

Дземешкевич¹,

Ragimov²,

Mikhaylov³

et al. 1998

Artificial Organs

View full text Add to dashboard Cite

After heart transplantation a number of factors such as pre- and postoperative hypoxia of the myocardium, myocardial failure of the early postoperative period, acute rejection episodes, cytomegalovirus infection, and finally the progressive atherosclerosis of the coronary arteries lead to the development of transplanted heart failure. Severe alterations of the myocardial function at this end stage of the process correspond to incurable cardiomyopathy. The target of plasmapheresis in this case is to decrease the extent of the disturbances in the lipoprotein contents and blood rheology for the improvement of the coronary perfusion of the transplanted heart. Nine patients with 3-7 year survival periods after heart transplantations underwent plasmapheresis twice a year using the Haemonetics PCS-plus machine. 2,100-2,700 ml of plasma was removed. Biochemical data, rheology and coagulation, and the concentration of Sandimmune (Sandoz Pharma Ltd., Basel, Switzerland) were controlled, and radionuclide scintigraphy of the myocardium, coronarographia, and transesophageal ultrasound investigations were completed for these patients. The result was the significant improvement of the coronary perfusion of the myocardium. The level of immunosuppression after the plasmapheresis procedures did not change and therefore did not demand any correction. Thus, we think that plasmapheresis can be an effective method of treatment of posttransplantation cardiomyopathy; the improvement of coronary perfusion decreases the extent of chronic ischemia. Further studies are necessary to answer the question as to whether it is possible to prolong the time before retransplantation with the help of plasmapheresis.

show abstract

“…In this study, gemfibrozil reduced triglyceride levels (P < 0.01) but did not reduce either total cholesterol or increase circulating HDL [75]. Peters et al [76] performed a retrospective analysis of the stepwise use gemfibrozil at two doses in posttransplant dyslipidemia (600 and 1200 mg daily, respectively). In all 52 patients (treated with gemfibrozil), there was a modest total cholesterol reduction of 7.4-7.0 mmol/l (287-272 mg/dL) after a mean treatment period of 5.4 months.…”

Section: Fibratesmentioning

confidence: 96%

Second Line Options for Hyperlipidemia Management after Cardiac Transplantation

Shah

Critchley

Yonan

et al. 2013

Cardiovascular Therapeutics

View full text Add to dashboard Cite

SUMMARYDespite widespread statin therapy, 91% of cardiac transplant patients have hyperlipidemia within 5 years from cardiac transplantation. The implications of this are profound, particularly given that coronary allograft vasculopathy is a leading cause of death. Unfortunately the solution is not easy, with problems of toleration at higher statin doses and a lack of good quality evidence for second line agents. We review the literature and discuss some of the key issues transplant physicians are faced with when considering alternatives to statin therapy.

show abstract

Treatment of hyperlipidemia in heart transplant recipients with gemfibrozil ± lovastatin

Cited by 16 publications

References 13 publications

Statin—Fibrate Combination Therapy

Statin—Fibrate Combination Therapy

Plasmapheresis in the Treatment of Posttransplant Cardiomyopathy

Second Line Options for Hyperlipidemia Management after Cardiac Transplantation

Contact Info

Product

Resources

About