The Role of Preoperative Chronic Statin Therapy in Heart Transplant Receipts—A Retrospective Single-Center Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patients
2.2. Management and Follow-Up
2.3. Statistical Analysis
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
References
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Total (n = 38) | Non-Statin (n = 27) | Statin (n = 11) | p Value | |
---|---|---|---|---|
Age, years (Mean, SD) | 41.21 (13.71) | 38.15 (14.74) | 48.73 (6.60) | 0.02 * |
BMI, kg/m2 (Mean, SD) | 23.81 (5.18) | 22.58 (5.48) | 26.84 (2.68) | 0.01 ** |
Pre-CRP, mg/L (Mean, SD) | 9.3 (12.2) | 10.8 (13.8) | 5.5 (6.0) | 0.27 ** |
Pre-LVEF, % (Mean, SD) | 26.37 (13.10) | 27.48 (15.28) | 23.64 (4.03) | 0.46 ** |
TC, mg/dL (Mean, SD) | 165.87 (44.81) | 164.37 (46.64) | 169.55 (41.87) | 0.75 * |
LDL-c, mg/dL (Mean, SD) | 106.05 (33.52) | 107.22 (34.53) | 103.18 (32.31) | 0.74 * |
HDL-c, mg/dL (Mean, SD) | 36.47 (10.43) | 34.85 (11.23) | 40.45 (7.06) | 0.12 ** |
non-HDl-c, mg/dL (Mean, SD) | 129.39 (39.88) | 129.52 (39.87) | 129.09 (41.86) | 0.97 * |
VLDL-c, mg/dL (Mean, SD) | 22.51 (10.66) | 20.86 (10.23) | 26.55 (11.10) | 0.09 ** |
TG, mg/dL (Mean, SD)s | 112.53 (53.32) | 104.30 (51.16) | 132.73 (55.51) | 0.09 ** |
Castelli risk index I (Mean, SD) | 4.78 (1.46) | 4.97 (1.44) | 4.33 (1.48) | 0.24 ** |
Castelli risk index II (Mean, SD) | 3.09 (1.19) | 3.26 (1.20) | 1.65 (1.10) | 0.16 ** |
AI (Mean, SD) | 3.78 (1.46) | 3.97 (1.44) | 3.33 (1.48) | 0.24 ** |
AIP (Mean, SD) | 0.47 (0.21) | 0.46 (0.21) | 0.49 (0.20) | 0.70 * |
Atorvastatin (n, %) | 8 (21.1) | 0 (0.0) | 8 (72.7) | - † |
Rosuvastatin (n, %) | 3 (7.9) | 0 (0.0) | 3 (27.3) | - † |
Spironolactone (n, %) | 30 (78.9) | 20 (74.1) | 10 (90.9) | 0.70 † |
Beta blockers (n, %) | 30 (78.9) | 19 (70.4) | 11 (100.0) | - † |
Carvedilol (n, %) | 27 (71.1) | 18 (66.7) | 9 (81.8) | 0.72 † |
ACE-I (n, %) | 17 (44.7) | 10 (37.0) | 7 (63.6) | 0.53 † |
Ramipril (n, %) | 12 (31.6) | 6 (22.2) | 6 (54.5) | 0.54 † |
Pre-AFib (n, %) | 8 (21.1) | 5 (18.5) | 3 (27.3) | 0.15 † |
Pre-Complete LBBB (n,%) | 6 (15.8) | 2 (7.4) | 4 (36.4) | - † |
Pre-CRT-D (n,%) | 8 (21.1) | 5 (18.5) | 3 (27.3) | 0.72 † |
Total (n = 38) | Non-Statin (n = 27) | Statin (n = 11) | p Value † | |
---|---|---|---|---|
Complications of any cause (n, %) | 30 (78.9) | 24 (88.9) | 6 (54.5) | 0.18 |
Acute graft rejection (n, %) | 7 (18.4) | 5 (18.5) | 2 (18.2) | 0.81 |
T2DM (n, %) | 8 (21.1) | 5 (18.5) | 3 (27.3) | 0.50 |
AFib (n, %) | 6 (15.8) | 5 (18.5) | 1 (9.1) | 0.09 |
AKI (n, %) | 12 (31.6) | 6 (22.2) | 6 (54.5) | 0.65 |
Complications OR/95%CI | Acute Graft Rejection OR/95%CI | T2DM OR/95%CI | AFib OR/95%CI | AKI OR/95%CI | |
---|---|---|---|---|---|
Statin | 0.06 0.008–0.56 p = 0.0128 | 1.30 0.12–13.91 | 6.14 0.64–58.73 | 0.25 0.01–4.62 | 6.90 1.03–45.94 p = 0.0458 |
Atorvastatin | 0.02 0.001–0.46 p = 0.0132 | 3.19 0.18–55.68 | 29.73 1.19–741.76 p = 0.0387 | 0.44 0.01–11.17 | 17.00 1.26–228.62 p = 0.0326 |
Spironolactone | - * - | 0.88 0.10–7.57 | 0.31 0.03–2.45 | - *- | 5.45 0.49–59.97 |
Beta blocker | 1.02 0.14–7.37 | - * - | 1.51 0.12–17.94 | 1.46 0.12–17.02 | 0.45 0.08–2.44 |
Carvedilol | 1.20 0.20–6.87 | 2.17 0.21–22.38 | 3.12 0.30–32.25 | 0.67 0.09–5.09 | 0.50 0.10–2.37 |
ACE-I | 1.41 0.25–7.80 | 1.96 0.32–11.80 | 1.42 0.24–8.38 | 0.18 0.01–1.80 | 1.61 0.36–7.12 |
Ramipril | 1.12 0.17–7.32 | 1.72 0.27–10.72 | 3.06 0.51–18.06 | 0.31 0.02–3.27 | 1.30 0.27–6.30 |
Statin + Spironolactone | 0.02 0.001–0.39 p = 0.0081 | 1.81 0.12–27.41 | 14.54 0.84–249.74 | 0.24 0.008–7.01 | 15.74 1.36–181.94 p = 0.0273 |
Atorvastatin + Spironolactone | 0.02 0.001–0.46 p = 0.0132 | 3.19 0.18–55.68 | 29.73 1.19–741.76 p = 0.0387 | 0.44 0.01–11.17 | 17.00 1.26–228.62 p = 0.0326 |
Statin + Spironolactone + Carvedilol | 0.02 0.001–0.46 p = 0.0132 | 3.19 0.18–55.68 | 29.73 1.19–741.76 p = 0.0387 | 0.44 0.01–11.17 | 17.00 1.26–228.62 p = 0.0326 |
Atorvastatin + Spironolactone + Carvedilol | - * - | 3.98 0.18–84.42 | - * - | 0.640.02–19.23 | 11.580.77–173.63 |
Spironolactone + Carvedilol | 0.71 0.13–3.79 | 0.97 0.17–5.32 | 1.33 0.24–7.16 | 1.52 0.23–9.71 | 1.01 0.24–4.20 |
Atorvastatin + Spironolactone + Ramipril | 0.05 0.002–1.60 | 0.97 0.02–44.33 | 19.94 0.53–736.62 | - * - | 29.25 1.58–538.60 p = 0.0231 |
Spironolactone + Ramipril | 0.67 0.09–4.77 | 1.03 0.12–8.35 | 5.55 0.84–36.46 | 0.37 0.03–4.21 | 1.94 0.37–10.04 |
Atorvastatin + Spironolactone + Carvedilol + Ramipril | - * - | 0.73 0.02–24.16 | - * - | 0.93 0.04–17.49 | 9.25 0.65–130.86 |
Spironolactone + Carvedilol + Ramipril | 0.47 0.06–3.57 | 1.16 0.14–9.41 | 7.19 1.04–49.34 p = 0.0446 | 0.42 0.03–5.08 | 1.25 0.22–7.18 |
Cut-Off | AUC | Standard Error | 95%CI | Sensitivity | Specificity | |
---|---|---|---|---|---|---|
CRP (mg/L) | 2.6 | 0.633 | 0.135 | 0.462–0.783 | 80.00 | 62.50 |
TC (mg/dL) | 153 | 0.646 | 0.126 | 0.474–0.794 | 70.00 | 75.00 |
LDL-c (mg/dL) | 91 | 0.683 | 0.124 | 0.513–0.824 | 80.00 | 75.00 |
Complications OR/95%CI | Acute Graft Rejection OR/95%CI | T2DM OR/95%CI | AFib OR/95%CI | AKI OR/95%CI | |
---|---|---|---|---|---|
CRP > 2.6 mg/L | 7.64 1.24–46.83 p = 0.0279 | 0.80 0.11–5.81 | 0.69 0,09–4.89 | 0.69 0.09–5.33 | 0.760.14–3.99 |
TC > 153 mg/dL | 8.76 1.24–61.66 p = 0.0293 | 4.47 0.38–52.29 | 1.24 0.16–9.27 | 0.38 0.05–2.91 | 0.98 0.18–5.14 |
LDL-c > 91 mg/dL | 11.25 1.54–82.15 p = 0.0169 | 3.00 0.22–40.81 | 1.61 0.14–17.69 | 3.42 0.19–59.41 | 0.55 0.09–3.07 |
Drug | CRP | |||
---|---|---|---|---|
r Value | 95%CI Lower Limit | 95%CI Upper Limit | χ2 Test p Value | |
Statin | −0.18 | −0.48 | 0.15 | 0.23 |
Atorvastatin | −0.30 | −0.57 | 0.02 | 0.03 |
Spironolactone | −0.22 | −0.51 | 0.11 | 0.07 |
Carvedilol | −0.34 | −0.60 | 0.01 | 0.45 |
Ramipril | −0.03 | −0.36 | 0.29 | 0.71 |
Statin + Spironolactone | −0.22 | −0.51 | 0.10 | 0.11 |
Atorvastatin + Spironolactone | −0.30 | −0.57 | 0.02 | 0.03 |
Statin + Spironolactone + Carvedilol | −0.33 | −0.59 | 0.008 | 0.03 |
Atorvastatin + Spironolactone + Carvedilol | −0.40 | −0.64 | 0.08 | 0.01 |
Atorvastatin + Spironolactone + Ramipril | −0.16 | −0.46 | 0.17 | 0.14 |
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Baba, D.-F.; Suciu, H.; Avram, C.; Danilesco, A.; Moldovan, D.A.; Rauta, R.C.; Huma, L.; Sin, I.A. The Role of Preoperative Chronic Statin Therapy in Heart Transplant Receipts—A Retrospective Single-Center Cohort Study. Int. J. Environ. Res. Public Health 2023, 20, 3471. https://doi.org/10.3390/ijerph20043471
Baba D-F, Suciu H, Avram C, Danilesco A, Moldovan DA, Rauta RC, Huma L, Sin IA. The Role of Preoperative Chronic Statin Therapy in Heart Transplant Receipts—A Retrospective Single-Center Cohort Study. International Journal of Environmental Research and Public Health. 2023; 20(4):3471. https://doi.org/10.3390/ijerph20043471
Chicago/Turabian StyleBaba, Dragos-Florin, Horatiu Suciu, Calin Avram, Alina Danilesco, Diana Andreea Moldovan, Radu Catalin Rauta, Laurentiu Huma, and Ileana Anca Sin. 2023. "The Role of Preoperative Chronic Statin Therapy in Heart Transplant Receipts—A Retrospective Single-Center Cohort Study" International Journal of Environmental Research and Public Health 20, no. 4: 3471. https://doi.org/10.3390/ijerph20043471