Cardiometabolic profile and characteristics of lipid-lowering therapy in liver transplant recipients in the practice of a cardiologist

Aim. To characterize the cardiometabolic profile, intake rate and effectiveness of lipid-lowering therapy (LLT) in liver transplant recipients.

Material and methods. This cross-sectional observational study was conducted, analyzing retrospective and current clinical data from patients who had undergone liver transplantation and were referred by a hepatologist for cardiologist consultation. The study included 74 subjects aged 61 (56-65) years (men, 60,8%). The period after liver transplantation was 2,8 (1,1-7,6) years. Cardiometabolic risk factors for atherosclerosis, laboratory and imaging data, and medications were analyzed.

Results. A high prevalence of following cardiometabolic risk factors was identified: atherogenic dyslipidemia (91,9%), hypertension (87,8%), carbohydrate metabolism disorders (58,1%), including type 2 diabetes (50,0%), and abdominal obesity (78,4%). Mixed hyperlipidemia was the predominant lipid metabolism disorder (48,6%), followed by pure hypercholesterolemia (31,1%) and pure hypertriglyceridemia (8,1%). Hypoalphacholesterolemia was detected in 4,1%. One in five patients with hyperlipidemia (21,5%) had severe hypercholesterolemia (low-density lipoprotein cholesterol >4,9 mmol/L). Despite the fact that 95,9% of patients had high or very high cardiovascular risk (CVR), only 9,5% received LLT associated with a reduction in CVR. Only 2 patients (2,7%) achieved target LDL cholesterol levels.

Conclusion. Liver transplant recipients referred to a cardiologist have a high prevalence of cardiometabolic risk factors, and the dyslipidemia pattern is characterized by a predominance of mixed hyperlipidemia. A discrepancy was identified between high CVR and the extremely low proportion of individuals taking pathogenetic hormonal therapy, necessitating an optimized interdisciplinary approach to the management of these patients.

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