Rhabdomyolysis in Patients Receiving Lovastatin after Cardiac Transplantation

To the Editor: A major factor limiting the long-term survival of patients after orthotopic cardiac transplantation is coronary-artery atherosclerosis.¹ Coronary atherosclerosis occurs at an accelerated rate in such patients as compared with persons with native hearts, affecting up to 33 percent of patients who survive for more than a year after transplantation.² Because hyperlipidemia after cardiac transplantation may contribute to atherosclerosis affecting the transplanted heart,^{3, 4} six patients with marked hypercholesterolemia after transplantation were treated with lovastatin during experimental testing in two cities. In four of these six patients (Table 1), severe rhabdomyolysis developed while they were receiving lovastatin in addition.