Changes in lipoprotein(a) concentration after orthotopic heart transplantation

Background Elevated concentrations of lipoprotein(a) have been considered an important risk factor in the development of premature cardiovascular disease and have been proposed as a risk factor in the development of accelerated cardiac allograft vasculopathy after orthotopic heart transplantation. Methods We prospectively measured lipoprotein(a), fasting cholesterol, and triglyceride concentrations before (n = 38), 6 months (n = 38), and 1 year (n = 21) after orthotopic heart transplantation. The mean age of the patients was 52 ± 2 years. Eighty-seven percent of the patients were men, 82% were white, and 61% had ischemic cardiomyopathy. Results Mean lipoprotein(a) concentration was lower 6 months after transplantation than it was before the operation (23 ± 3 mg/dL vs 17 ± 3 mg/dL; P = .014) and remained low 1 year after transplantation (23 ± 3 mg/dL vs 18 ± 4 mg/dL; P = not significant). In contrast, mean cholesterol concentration was higher 6 months after transplantation (171 ± 8 mg/dL vs 221 ± 8 mg/dL; P < .001) and 1 year (171 ± 8 mg/dL vs 205 ± 10 mg/dL; P < .01) than it was before transplantation. Triglyceride concentration was higher 1 year after transplantation than it was before the operation (146 ± 13 mg/dL vs 184 ± 20 mg/dL; P = .017). Conclusions Lipoprotein(a) concentrations decrease during the 6 months after transplantation and stay low for at least 1 year after the operation. Additional studies are needed to ascertain the effect these changes in lipoprotein(a) concentration on the development of cardiac allograft vasculopathy.