Cholesterol-lowering drug improves survival after heart transplant

FDA Consumer, Jan-Feb, 2003

Transplanted hearts stayed healthier in people who took a cholesterol-lowering drug, according to a new, eight-year study.

Researchers found that the survival rate for transplant patients who received early simvastatin treatment was 88.6 percent compared with 59.5 percent of patients who didn't start simvastatin treatment until four years after transplant, says Klaus Wenke, M.D., lead author of the paper and assistant professor in the division of cardiac surgery at Munich-Bogenhausen, Munich, Germany. Results of the study were published in the Dec. 6, 2002, rapid access issue of Circulation: Journal of the American Heart Association.

The authors also studied the effects of simvastatin on the development of coronary artery thickening called transplant vasculopathy, which is a major long-term complication of heart transplantation. Early simvastatin treatment cut in half the incidence of vessel thickening as measured by angiography, which probably explained the improved survival rate. After eight years, 54.7 percent of the patients in the untreated group had developed transplant vasculopathy, compared to just 24.4 percent of patients in the simvastatin group.

Wenke and colleagues studied 72 patients who had heart transplants beginning in 1991. All patients were put on a strict low-cholesterol diet after surgery. Thirty-five patients started daily simvastatin treatment four days after transplant, while 37 remained on dietary therapy alone. After four years, the results in the simvastatin group were "significantly better," so all patients were offered simvastatin, says Wenke.

Benefits of simvastatin may be due not only to its ability to reduce cholesterol, but also to its ability to reduce the growth of smooth muscle cells (cells in the vessel wall that contribute to vessel thickening).

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