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.