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Low HDL‐C predicts the onset of transplant vasculopathy in pediatric cardiac recipients on pravastatin therapy
Author(s) -
Hedman Mia,
Pahlman Raija,
Sundvall Jouko,
Ehnholm Christian,
Syvänne Mikko,
Jokinen Eero,
Jauhiainen Matti,
Holmberg Christer,
Antikainen Marjatta
Publication year - 2007
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2007.00690.x
Subject(s) - pravastatin , medicine , apolipoprotein b , gastroenterology , transplantation , endocrinology , cholesterol , prospective cohort study , cardiology
The levels and protein/lipid compositions of major lipoprotein particles of 19 pediatric cardiac transplant recipients (4–18 yr of age) were studied in this prospective, open clinical follow‐up study before and at one yr of pravastatin therapy (10 mg/day). The recipients were grouped into those with (n = 6; group A) and those without (n = 13; group B) angiographically detectable vasculopathy. Twenty‐one pediatric non‐transplant controls were studied at baseline. At baseline, the group A recipients had 29% lower HDL‐C concentrations (p = 0.031) and 29% higher apoB‐100/apoA‐I ratios (p = 0.034) than the group B recipients. At one yr of pravastatin, the respective figures were 29% (p = 0.013) and 33% (p = 0.005). Compared with the healthy pediatric controls, the transplant recipients had significantly higher serum TG before pravastatin [median (range): 1.3 mmol/L (0.6–3.2) vs. 0.7 mmol/L (0.3–2.4), p = 0.0002] and at one yr [1.3 mmol/L (0.5–3.5) vs. 0.7 mmol/L (0.3–2.4), p = 0.0004]. The baseline apoB‐100/apoA1 ratios of the recipients were 33% higher (p = 0.005). In conclusion, low HDL‐C and high apoB‐100/apoA‐I ratio were associated with angiographically detectable vasculopathy. Even though pravastatin effectively lowered the TC and LDL‐C and improved compositional properties of LDL and HDL 2 particles, it failed to normalize the elevated TG and, in some patients, to prevent the progression of transplant vasculopathy.