Journal article
Uncertain benefit of statins in pediatric heart transplant recipients: A PHTS analysis
The Journal of heart and lung transplantation, Vol.43(5), pp.703-713
12/06/2023
DOI: 10.1016/j.healun.2023.11.021
PMID: 38065240
Abstract
Cardiac allograft vasculopathy (CAV) is a leading cause of graft failure in pediatric heart transplant recipients (HTRs). Early statin use has been shown to reduce CAV incidence and all-cause mortality in adult HTRs. We sought to evaluate the contemporary prevalence and trends of statin use in pediatric HTRs and the association between statin use with CAV development and graft failure.
Patients aged <17 years at the time of primary heart transplant who survived to ≥3 years without CAV were identified from the Pediatric Heart Transplant Society database (2001-2018). Statin use in the first 3 years posttransplant was defined as consecutive, intermediate, or absent. Kaplan-Meier survival, multivariable modeling, and propensity score-matched analyses evaluated associations between statin use and CAV incidence and graft survival, with subanalyses performed on subjects aged ≥10 years at transplant.
Among 3,485 (of which 1,086 aged ≥10 years) HTRs, 584 (17%) received consecutive statin therapy, 647 (19%) received intermediate use, and 2,254 (65%) received no statin therapy. Statin use varied widely between sites, with increasing use in the ≥10-year-old cohort over time. By multivariate analysis, statin use was not associated with graft loss. Consecutive statin use was also not associated with graft survival or freedom from CAV development when compared to absent statin use in unmatched or propensity-matched analyses.
While statins remain commonly utilized in pediatric HTRs, early consecutive statin therapy did not decrease CAV incidence or graft loss. The differing effects of statins on CAV development and progression in pediatric vs adult HTRs suggest differing risk and mediating factors and require further study.
Details
- Title: Subtitle
- Uncertain benefit of statins in pediatric heart transplant recipients: A PHTS analysis
- Creators
- Madeleine Townsend - Cleveland ClinicMichael Khoury - University of AlbertaDevin Koehl - University of Alabama at BirminghamJames K Kirklin - University of Alabama at BirminghamRyan Cantor - University of Alabama at BirminghamGary Beasley - University of IowaChiu-Yu Chen - Lucile Packard Children's HospitalGerard Boyle - Cleveland ClinicJohn J Parent - Riley Hospital for ChildrenNathanya Baez Hernandez - Children's Medical Center Dallas UT Southwestern, Dallas, TexasNancy Halnon - Mattel Children's Hospital
- Resource Type
- Journal article
- Publication Details
- The Journal of heart and lung transplantation, Vol.43(5), pp.703-713
- DOI
- 10.1016/j.healun.2023.11.021
- PMID
- 38065240
- eISSN
- 1557-3117
- Language
- English
- Electronic publication date
- 12/06/2023
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics
- Record Identifier
- 9984530279802771
Metrics
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