Résumé
Heart transplantation is the gold standard treatment for end-stage heart failure. Dyslipidemia is more common in transplant patients than in the general population, particularly due to immunosuppressants and the first-line treatment to manage dyslipidemia in transplant recipients is based on the use of statins. However, their use must be monitored closely because of potential drug interactions that can lead to statin overdoses and adverse effects. Thus, European guidelines recommend the use of low or moderate-intensity statins in these patients, regardless of LDL-C levels or concomitant treatments. Transplanted patients require strict cholesterol control, and current methods may not be enough to achieve these goals.A descriptive, prospective, single-center study was conducted, including all subjects over 18 years old who had undergone a heart transplant and/or were being followed up at the CHU of Montpellier, a total of 50 patients. These patients completed a self-questionnaire and participated in a semi-structured interview with the pharmacy intern, and an analysis of biological, angiographic, sociodemographic, and treatment data showed that achieving targets was difficult with current therapies. Only 20% of the followed patients had LDL-C within their target range, with an average LDL-C of 0.75 +/- 0.36 g/l. Patients treated with pravastatin (low to moderate-intensity statin) were less likely to reach their LDL-C target compared to patients treated with Atorvastatin (moderate or high intensity) (29% vs. 48%; p=0.067).This study highlights the difficulty of reaching the LDL-C target recommended by the ESC with current medications. Anti-PCSK9 antibodies might be the right alternative for patients who are not meeting the target.