Safety and Efficacy of PCSK9 Inhibitors After Heart Transplantation

Yasbanoo Moayedi; Stella Kozuszko; Joshua W Knowles; Sharon Chih; Gabriela Oro; Roy Lee; William F Fearon; Heather J Ross; Jeffrey J Teuteberg; Kiran K Khush

doi:10.1016/j.cjca.2018.11.004

Safety and Efficacy of PCSK9 Inhibitors After Heart Transplantation

Can J Cardiol. 2019 Jan;35(1):104.e1-104.e3. doi: 10.1016/j.cjca.2018.11.004. Epub 2018 Nov 14.

Authors

Affiliations

¹ Stanford University, Division of Cardiovascular Medicine, Heart Transplantation, Palo Alto, California, USA; Ted Rogers Centre of Excellence in Heart Function, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada.
² Ted Rogers Centre of Excellence in Heart Function, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada.
³ Stanford Cardiovascular Institute, Stanford University, Palo Alto, California, USA.
⁴ University of Ottawa, Heart Institute, Division of Cardiology, Ottawa, Ontario, Canada.
⁵ Stanford University, Division of Cardiovascular Medicine, Heart Transplantation, Palo Alto, California, USA.
⁶ Stanford University, Division of Cardiovascular Medicine, Heart Transplantation, Palo Alto, California, USA. Electronic address: [email protected].

PMID: 30595172
DOI: 10.1016/j.cjca.2018.11.004

Abstract

Dyslipidemia is common in patients undergoing heart transplantation and is associated with the progression of cardiac allograft vasculopathy. Two monoclonal antibodies directed against PCSK9i-evolocumab and alirocumab-are currently available. However, their use, safety and efficacy in the post-transplant setting have not been studied. We present our experience with 6 heart transplant recipients treated with a PCSK9i. A > 70% reduction in LDL-cholesterol was observed after evolocumab therapy. PCSK9 inhibitors are a potentially lipid-lowering therapeutic option for heart transplant patients with suboptimal LDL despite maximal tolerated statin doses.

Publication types

Case Reports

MeSH terms

Adult
Aged
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized
Anticholesteremic Agents / therapeutic use
Dyslipidemias / complications
Dyslipidemias / drug therapy*
Female
Graft Rejection / blood
Graft Rejection / etiology
Graft Rejection / prevention & control*
Heart Transplantation / adverse effects*
Humans
Lipids / blood*
Male
Middle Aged
PCSK9 Inhibitors*
Proprotein Convertase 9 / blood
Treatment Outcome

Substances

Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Anticholesteremic Agents
Lipids
PCSK9 Inhibitors
PCSK9 protein, human
Proprotein Convertase 9
evolocumab