Statins may help keep heart-transplant patients alive longer, say researchers from Munich-Bogenhausen, University Hospital Munich-Grosshadern, and University Hospital Leipzig. According to an eight-year prospective, randomized, unmasked study of 72 patients, 89% of those who were given simvastatin (Zocor medication, Merck) four days after transplantation survived, in contrast to 60% of patients who didn’t start a statin regimen until four years later. All patients had been given a strict low-cholesterol diet after surgery. Thirty-five patients were receiving daily statin treatment, and 37 were receiving dietary therapy alone.
The average ages of patients were 49 in the simvastatin group and 47 in the control group. The average donor age was 30 for the simvastatin transplant recipients and 34 for the control-arm recipients.
After four years, the benefits of sim-vastatin were so much better that all of the patients were offered the drug. The long-term effects might be explained, in part, the researchers say, by the drug’s efficacy in lowering cholesterol levels and thereby reducing the incidence of transplant vasculopathy, a major complication of heart transplantation characterized by thickening of the coronary artery. Early simvastatin treatment halved the incidence of vessel thickening; by eight years after the surgery, transplant vasculopathy occurred in only 24% of the patients taking statins but developed in 55% of the patients being treated with diet alone. There was no difference in organ function between the two groups.
Four patients in the diet-alone (control) group died as a result of transplant vasculopathy, whereas only one transplant patient died in the group receiving simvastatin. No severe adverse effects from the therapy were documented up to the end of the eight-year observation period.
The researchers suggested that sim-vastatin might be successful in reducing not only cholesterol levels but also the growth of smooth muscle cells, which contribute to vessel thickening.