Low HDL-C predicts the onset of transplant vasculopathy in pediatric cardiac recipients on pravastatin therapy

Mia Hedman, Raija Pahlman, Jouko Sundvall, Christian Ehnholm, Mikko Syvänne, Eero Jokinen, Matti Jauhiainen, Christer Holmberg, Marjatta Antikainen

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"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-1 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 angio-graphically detectable vasculopathy. Even though pravastatin effectively lowered the TC and LDL-C and improved compositional properties of LDL and HDL2 particles, it failed to normalize the elevated TG and, in some patients, to prevent the progression of transplant vasculopathy."
Original languageEnglish
JournalPediatric Transplantation
Pages (from-to)481-490
Number of pages10
Publication statusPublished - 2007
MoE publication typeA1 Journal article-refereed

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