Progression of aortic valve sclerosis and aortic valve stenosis: what is the role of statin treatment?
BACKGROUND
It has recently been suggested that statins could slow the progression of aortic stenosis, but this hypothesis has not been validated in large series. Moreover, there is little information about the role of statin treatment in patients with aortic valve sclerosis.


METHODS
From our database 1988--2002, we retrospectively identified 1136 consecutive patients with aortic valve sclerosis (peak aortic velocity [Vmax] > 1.5 and < 2 m/s), or mild to moderate aortic stenosis (Vmax 2.0-3.9 m/s) and with > or = 2 echocardiographic studies > or = 6 months apart; 121 (11 %) were treated with statins. As a control group we randomly selected 121 age-gender-matched patients not treated with statins, with similar initial Vmax.


RESULTS
The mean follow-up duration was 54+/-34 months in the statin group, and 50+/-33 months in controls (p = 0.35). There were no differences between statin-treated patients and controls with respect to age, gender, and prevalence of hypertension. More patients in the statin group had documented hypercholesterolemia, diabetes, or had proven coronary artery disease. Overall, the rate of change of Vmax was not different between statin-treated patients and controls (0.13+/-0.24 vs 0.14+/-0.19 m/s/year, p = 0.72). However, in the subgroup of patients with aortic valve sclerosis (n = 52, 26 statin-treated, 26 controls), the rate of change of Vmax was significantly lower in statin-treated patients (0.04+/-0.04 vs 0.08+/-0.06 m/s/year, p = 0.007).


CONCLUSIONS
The results of our retrospective study show that statins could be beneficial in retarding the progression of valvular aortic sclerosis to aortic stenosis. This suggests that statins retard the progression of aortic valve lesion in its early stage, a finding that may have important implications in the management of this very common disease.
Antonini-Canterin
Francesco
F
S Maria degli Angeli Hospital, Pordenone, Italy. cardiologia@aopn.fvg.it
Popescu
Bogdan A
BA
Huang
Guoqian
G
Korcova-Miertusova
Renata
R
Rivaben
Dante
D
Faggiano
Pompilio
P
Pavan
Daniela
D
Piazza
Rita
R
Bolis
Angiola
A
Ciavattone
Antonio
A
Ruggiero
Alberto
A
Nicolosi
Gian Luigi
GL
D000368:Aged; D001021:Aortic Valve / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000188:drug therapy* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies; D012598:Sclerosis
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors