Atorvastatin Therapy Is Not Associated with Slowing the Progression of Aortic Stenosis: Findings of a Randomized Controlled Trial

Panahi, Yunes; Sahebkar, Amirhossein; Taghipour, Hamid Reza; Dadjou, Yahya; Pishgoo, Bahram; Rakhshankhah, Amir Sobh

doi:10.7754/clin.lab.2012.120319

Cited by 12 publications

(7 citation statements)

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“…In fact, rates of AV replacement were the same (myocardial infarction 1.00, 95% CI 0.84 to 1.18). Similar results were observed in studies of rosuvastatin and atorvastatin (Table ) . Additionally, several meta‐analyses found no significant differences between subjects treated with and without statins in terms of major echocardiographic findings (mean AV pressure gradient and AV area) or overall clinical outcomes .…”

Section: Potential Medical Therapies For Avssupporting

confidence: 81%

“…Similar results were observed in studies of rosuvastatin and atorvastatin (Table 4). [66][67][68][69] Additionally, several meta-analyses found no significant differences between subjects treated with and without statins in terms of major echocardiographic findings (mean AV pressure gradient and AV area) or overall clinical outcomes. [70][71][72] These collective findings suggest that (1) statins are unlikely to significantly affect the course of AS, (2) AVS may be a more appropriate target for statins but further research is needed given the scarcity of data, and (3) statins have multifactorial effects that may not be fully characterized yet.…”

Section: Statinsmentioning

confidence: 99%

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Insights Into Aortic Sclerosis and Its Relationship With Coronary Artery Disease

Milin

Vorobiof

Aksoy

et al. 2014

JAHA

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Section: Potential Medical Therapies For Avssupporting

confidence: 81%

Section: Statinsmentioning

confidence: 99%

Insights Into Aortic Sclerosis and Its Relationship With Coronary Artery Disease

Milin

Vorobiof

Aksoy

et al. 2014

JAHA

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“…In our cohort, patients with fast progress of P mean had higher levels of LDL-C, independent of age, sex, and LVEF. In line with these findings, former studies also revealed higher values of LDL-C to be a risk factor for AS [ 23 ] although no benefit from statin therapy on valve function and calcification could be found so far [ 24 , 25 ]. Paradoxically, LDL-C was an independent risk factor for faster progress of P mean in our cohort in the context of similar statins application between the two groups, whereas prevalence of coronary artery disease was higher in the slow progression group.…”

Section: Discussionmentioning

confidence: 58%

Association between Comorbidities and Progression of Transvalvular Pressure Gradients in Patients with Moderate and Severe Aortic Valve Stenosis

Salinger

Liú

et al. 2018

Cardiology Research and Practice

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Background Fast progression of the transaortic mean gradient (P mean) is relevant for clinical decision making of valve replacement in patients with moderate and severe aortic stenosis (AS) patients. However, there is currently little knowledge regarding the determinants affecting progression of transvalvular gradient in AS patients. Methods This monocentric retrospective study included consecutive patients presenting with at least two transthoracic echocardiography examinations covering a time interval of one year or more between April 2006 and February 2016 and diagnosed as moderate or severe aortic stenosis at the final echocardiographic examination. Laboratory parameters, medication, and prevalence of eight known cardiac comorbidities and risk factors (hypertension, diabetes, coronary heart disease, peripheral artery occlusive disease, cerebrovascular disease, renal dysfunction, body mass index ≥30 Kg/m2, and history of smoking) were analyzed. Patients were divided into slow (P mean < 5 mmHg/year) or fast (P mean ≥ 5 mmHg/year) progression groups. Results A total of 402 patients (mean age 78 ± 9.4 years, 58% males) were included in the study. Mean follow-up duration was 3.4 ± 1.9 years. The average number of cardiac comorbidities and risk factors was 3.1 ± 1.6. Average number of cardiac comorbidities and risk factors was higher in patients in slow progression group than in fast progression group (3.3 ± 1.5 vs 2.9 ± 1.7; P=0.036). Patients in slow progression group had more often coronary heart disease (49.2% vs 33.6%; P=0.003) compared to patients in fast progression group. LDL-cholesterol values were lower in the slow progression group (100 ± 32.6 mg/dl vs 110.8 ± 36.6 mg/dl; P=0.005). Conclusion These findings suggest that disease progression of aortic valve stenosis is faster in patients with fewer cardiac comorbidities and risk factors, especially if they do not have coronary heart disease. Further prospective studies are warranted to investigate the outcome of patients with slow versus fast progression of transvalvular gradient with regards to comorbidities and risk factors.

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“…We searched a medical database (PubMed) using the MeSH keywords (“aortic valve stenosis” and “Hydroxymethylglutaryl-CoA Reductase Inhibitors”) together and in combination, having limited the search to studies reported only in English prior to April 2015 and those which used adults ≥19 years of age. Fourteen studies were identified including 5 RCTs [2] , [3] , [4] , [5] , [6] and 9 observational studies [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] . The mean follow-up period of the studies ranged between 12 months and 5.6 years.…”

Section: Experimental Design Materials and Methodsmentioning

confidence: 99%

The effect of statins therapy in aortic stenosis: Meta-analysis comparison data of RCTs and observationals

Zhao

Nicoll

et al. 2016

Data in Brief

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Aortic stenosis has been shown to share the same risk factors as atherosclerosis which suggested a potential benefit from statins therapy. Fourteen studies which provided the effect of statins treatment on aortic stenosis (AS) were meta-analyzed, including 5 randomized controlled trials (RCTs) and 9 observational studies. In the RCTs, statins did not have any influence on peak aortic valve velocity, peak valve gradient, mean valve gradient, aortic valve area and aortic calcification compared to controls. In the observational studies, the peak valve velocity, peak gradient and aortic valve area showed less progression in the statins group compared to controls. This article describes data related article title “The effect of statins on valve function and calcification in aortic stenosis: a meta-analysis” (Zhao et al., 2016) [1].

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Atorvastatin Therapy Is Not Associated with Slowing the Progression of Aortic Stenosis: Findings of a Randomized Controlled Trial

Cited by 12 publications

References 0 publications

Insights Into Aortic Sclerosis and Its Relationship With Coronary Artery Disease

Insights Into Aortic Sclerosis and Its Relationship With Coronary Artery Disease

Association between Comorbidities and Progression of Transvalvular Pressure Gradients in Patients with Moderate and Severe Aortic Valve Stenosis

The effect of statins therapy in aortic stenosis: Meta-analysis comparison data of RCTs and observationals

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