SERIAL EVALUATION OF LIPID PROFILES AND RISK-FACTORS FOR DEVELOPMENT OF HYPERLIPIDEMIA AFTER CARDIAC TRANSPLANTATION

To determine the prevalence, time course and factors responsible for hyperlipidemia after heart transplantation, 83 consecutive 1-year survivors were studied. By 1 year, 83% of patients had serum total cholesterol levels >5.2 mmol/liter (200 mg/dl) and 28% of the patients had serum total cholesterol higher than the age- and sex-matched ninety-fifth percentile. At the end of 1-year follow-up, serum total cholesterol correlated with the recipient age (p < 0.0001), the preoperative cholesterol level (p < 0.001), the actual dose of maintenance prednisone at 1 year (p < 0.02) and the cumulative 1-year steroid dose (p < 0.03). Similarly, the serum triglyceride level at 1 year correlated with the pretransplant level of serum triglycerides (p < 0.0001), recipient age (p < 0.03) and cumulative 1-year steroid dose (p < 0.03). Patients with a pretransplant diagnosis of coronary artery disease had a significantly higher level of serum total cholesterol and triglyceride levels at 1 year (p < 0.02 and p < 0.03, respectively). Heart transplant recipients with body mass index ≥25 kg/m2 also presented with significantly elevated serum total cholesterol and triglyceride levels at 1 year compared with nonobese patients (p < 0.01 and p < 0.002, respectively). Hyperlipidemia occurs frequently and is detected within the first month after heart transplantation. Optimal management of this problem requires further study. © 1990.