59
6.9. Cardiac Allograft Vasculopathy in Heart Transplant
Recipients
COR LOE
Recommendations
1 C-LD 1. In patients with cardiac allograft vasculopathy, statins are
recommended for secondary prevention to reduce MACE.
2a C-LD 2. In patients with cardiac allograft vasculopathy, aspirin can be
beneficial for secondary prevention to reduce MACE.
2a C-LD 3. In patients with severe cardiac allograft vasculopathy,
revascularization is reasonable in those with suitable anatomy
to potentially mitigate the adverse long-term consequences of
cardiac allograft vasculopathy.*
* Modified from the 2021 ACC/AHA/SCAI guideline for coronary artery revascularization.
Lawton JS, et al. op. cit.
Table 23. Common Antiretroviral Therapy Drugs and Effects
on Lipid Levels
Class Drug Effect on Blood Lipids
NRTIs Abacavir Increases total cholesterol, LDL-C, and HDL-C levels
Lamivudine Increases total cholesterol, LDL-C, and HDL-C levels
Tenofovir fumarate
disoproxil
Lowers LDL levels
Zidovudine Hypertriglyceridemia
NNRTIs Efavirenz Increases total cholesterol, LDL-C, HDL-C, and
triglyceride levels
Nevirapine Neutral or decreases lipid levels
Rilpivirine Neutral
Integrase
inhibitors
Dolutegravir Neutral
Raltegravir Increases HDL levels
* Although ritonavir is a protease inhibitor, this drug is generally used as a pharmacokinetic
enhancer.
Adapted from Hsue PY, et al. Nat Rev Cardiol. 2019;16:745-759. By permission from
Springer Nature, Copyright 2019.
(cont'd)
