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World Journal of Surgery
Published in: World Journal of Surgery 9/2014

01-09-2014

Graft Vessel Disease Following Heart Transplantation: A Systematic Review of the Role of Statin Therapy

Authors: Robin Som, Peter J. Morris, Simon R. Knight

Published in: World Journal of Surgery | Issue 9/2014

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Abstract

Background

Graft vessel disease (GVD) is a significant cause of morbidity and mortality in cardiac allograft recipients. Hyperlipidemia is a risk factor for GVD, and the majority of patients will display abnormal lipid profiles in the years following transplant.

Objective

This systematic review aims to establish the clinical impact of statins in cardiac allograft recipients, critically appraising the literature on this subject.

Methods

A literature search for randomized studies assessing statin use in cardiac allograft recipients was undertaken. The Cochrane Central Registry of Controlled Trials, MEDLINE, EMBASE, clinicaltrials.gov, and the Transplant Library from the Centre for Evidence in Transplantation were searched. The primary outcome was presence of GVD. Secondary outcomes included graft and patient survival, acute rejection, and adverse events. Meta-analysis was precluded by heterogeneity in outcome reporting and therefore narrative synthesis was undertaken.

Results

Seven randomized controlled trials (RCTs) were identified. The majority of RCTs demonstrated some risk of bias, and methods of outcome measurement were variable. Studies reporting incidence or severity of GVD suggest that statins do confer benefit. Survival benefit from statin use is modest. There is a low incidence of adverse events attributable to statins. There was no difference in the overall number of episodes of rejection.

Conclusion

Whilst the methodological quality of evidence describing the use of statins in cardiac allograft recipients is limited, the available evidence suggests benefit from their use. This is compatible with the effects of statins in non-transplant patients with cardiovascular disease. Furthermore, the rate of adverse events in the trials is low.
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Metadata
Title
Graft Vessel Disease Following Heart Transplantation: A Systematic Review of the Role of Statin Therapy
Authors
Robin Som
Peter J. Morris
Simon R. Knight
Publication date
01-09-2014
Publisher
Springer US
Published in
World Journal of Surgery / Issue 9/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-014-2543-x

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