What class of medication should a patient be discharged on to prevent coronary allograft vasculopathy after a heart transplant?

The correct choice is a statin, which is recommended for preventing coronary allograft vasculopathy (CAV) after heart transplantation. Statins play a critical role in managing cholesterol levels, reducing low-density lipoprotein (LDL) cholesterol, and providing pleiotropic effects that include improving endothelial function and having anti-inflammatory properties. These benefits can help reduce the risk of atherosclerosis and other vascular complications, including CAV, which is a significant long-term concern in heart transplant recipients.

Additionally, emerging evidence suggests that statins may directly inhibit the proliferation of smooth muscle cells in the transplanted coronary arteries, further aiding in the prevention of CAV. Regular use of statins post-transplant is associated with improved graft survival and decreases the incidence of vascular complications.

The other medication classes have different mechanisms and roles in post-transplant care, but are not specifically aligned with the primary goal of preventing CAV. For example, mTOR inhibitors are primarily used for immunosuppression, ACE inhibitors are beneficial for managing hypertension and heart failure, and corticosteroids are also used in the context of immunosuppression but are not targeted specifically for preventing CAV. Over time, their use can be associated with side effects that may complicate cardiovascular