Lipid-lowering therapies to target cardiac allograft vasculopathy after heart transplantation: Current evidence and future directions

BACKGROUND Heart transplantation represents an increasingly utilized procedure for end-stage heart failure patients. CURRENT EVIDENCE Cardiac allograft vasculopathy (CAV) is a post-transplant complication of pathological vasculature remodeling and remains an important cause for long-term graft failure and mortality. Current preventive strategies for CAV include optimization of vascular risk factors and pharmacotherapy with statins and immunosuppressants. CONCLUSION Despite demonstrated post-transplant mortality benefit and reduction in CAV with statins, the role of other pharmacotherapies on CAV reduction through LDL-C lowering remains less established. This review explores established evidence as well as evolving pathways for LDL-C lowering strategies to prevent CAV.