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Stage-Related Effect of Statin Treatment on the Progression of Aortic Valve Sclerosis and Stenosis

Domenii publicaţii > Ştiinţe medicale + Tipuri publicaţii > Articol în revistã ştiinţificã

Autori: Francesco Antonini-Canterin, Monica Hirsu, Bogdan Alexandru Popescu, Elisa Leiballi, Rita Piazza, Daniela Pavan, Carmen Ginghina, Gian Luigi Nicolosi

Editorial: The American Journal of Cardiology, 102, p.738-742, 2008.

Rezumat:

It has been suggested that statins could slow the progression of aortic stenosis (AS), but this hypothesis is still debated and has not been validated in large series of patients (pts) by long-term follow-up studies. Moreover, information about the role of statins in pts with different degrees of AS severity is scarce. From our 1988-2007 echocardiographic database, we retrospectively identified all asymptomatic pts with aortic valve sclerosis (abnormal irregular thickening of the aortic valve with a peak aortic velocity [Vmax]>=1.5 and <2 m/s), mild AS (Vmax >=2 and <3 m/s) and moderate AS (Vmax >=3 and <4 m/s), age >=50 years, and with >=2 echocardiographic studies >=2 years apart. Exclusion criteria were: moderate/severe aortic regurgitation, bicuspid aortic valve, rheumatic valve disease, ejection fraction <40%. The final study population consisted of 1046 pts (mean age 70+-8 years, 587 men), 309 treated with statins. Mean follow-up duration was 5.6+-3.2 years (range 2-19 years). Progression of AS was slower in pts receiving statins compared with untreated pts in aortic sclerosis (0.04+-0.09 m/s/y vs 0.07+-0.10 m/s/y, p=0.01) and mild AS (0.09+-0.15 m/s/y vs 0.15+-0.15 m/s/y, p=0.001), but not in moderate AS (0.21+-0.18 m/s/y vs 0.22+-0.15 m/s/y, p=0.70). In multivariate analysis only statin therapy, initial Vmax and dialysis were independently related to progression of aortic valve disease. In conclusion, in a large series of pts with long-term follow-up, statins were effective in slowing the progression of aortic valve disease in aortic sclerosis and mild AS, but not in moderate AS. These results suggest that statin therapy should be taken into consideration in the early stages of this common disease.

Cuvinte cheie: aortic stenosis, aortic sclerosis, statins, echocardiography