Serum lipids in cardiac transplant recipients with angiographic accelerated graft atherosclerosis

Accelerated graft atherosclerosis (AGA) is the leading cause of death in heart transplant patients after the first postoperative year. The role of hypercholesterolemia in the development of AGA remains controversial. Therefore, we studied fifty-two cardiac transplant patients who were referred for annual coronary angiography at a mean time of 43.5 ±32.5 months post transplantation. There was no significant difference in the time from transplant or the presence of diabetes between patients with and without AGA. Angiograms were classified as demonstrating AGA or not by the presence or absence of previously described angiographie abnormalities seen in transplant patients. Fasting serum levels of total cholesterol, LDL, HDL, and triglycérides were measured at the time of angiography. Total CholesterolLDLHDL Triglycérides (mg/dl) (mg/dl) (mg/dl) (mg/dl) (-)AGA 191±34 117+34 47±10 139+78 n=14 n=14 n=14 n=14 (+)AGA 221+47* 131+37 48⁺17 246+236 n=38 n=32 n=38 n=38 *p < .05 compared to (-)AGA Cardiac transplant patients with evidence of AGA on coronary angiography had a significantly higher level of total serum cholesterol than those who had normal angiograms. The role of lipids in the development and progression of AGA merits further study.