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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Effect of statin treatment on aortic valve and coronary artery calcification
Emile R Mohler1, Hao Wang, Elizabeth Medenilla
1Department of Medicine, Cardiovascular Division, University of Pennsylvania School of Medicine, University Hospital, Philadelphia 19104, USA. mohlere@uphs.upenn.edu
Insights
Statins did not significantly reduce aortic valve calcification but slowed coronary artery calcification progression. High-sensitivity C-reactive protein levels predicted calcification progression in both arteries, indicating potential for targeted therapies.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biomarkers
Background:
- Conflicting data exist on statin efficacy in aortic valve disease.
- Inflammatory status may influence aortic valve calcification progression.
- Further research is needed to clarify statin's role in aortic valve disease.
Purpose of the Study:
- To evaluate statin's effect on aortic valve and coronary artery calcification.
- To compare statin's impact with patients' inflammatory status.
- To investigate the role of inflammatory biomarkers in calcification progression.
Main Methods:
- Prospective observational study of 61 patients with moderate to severe aortic stenosis.
- Baseline and one-year assessments included echocardiography and electron-beam computed tomography.
- Measurement of inflammatory biomarkers (hsCRP) and lipid profiles (LDL).
Main Results:
- No significant reduction in aortic valve calcification with statins, but a trend towards slower progression.
- Significant inhibition of coronary artery calcification volume score in the statin group.
- High-sensitivity C-reactive protein levels correlated significantly with progression of both aortic valve and coronary artery calcification.
Conclusions:
- Statin treatment did not significantly benefit aortic valve calcification but decreased coronary artery calcification progression.
- Baseline hsCRP levels predict calcification progression, identifying high-risk patients.
- Emerging anti-inflammatory drugs may offer new therapeutic avenues for atherosclerosis.
Background And Aim Of The Study:
Conflicting data exist regarding statins and the progression of aortic valve disease. Hence, further information is required to determine if statin treatment has a beneficial effect on aortic valve calcification, and whether the inflammatory status of the patient affects aortic valve disease progression. The study aim was to evaluate the concomitant effect of statin treatment on aortic valve and coronary artery calcification and to compare results with the inflammatory status of the patient.
Methods:
Sixty-one patients with moderate to severe aortic stenosis (AS) were enrolled in this single-center, prospective observational study evaluating progression of aortic valve calcification. Patients underwent baseline and one-year echocardiography and electron-beam computed tomography. Blood samples were withdrawn at baseline and at one year for measurement of inflammatory biomarkers.
Results:
There was no significant reduction in calcium accumulation in the aortic valve of the statin group compared to the non-statin group, but there was trend towards less progression of calcification for the statin group. A significant inhibition of the coronary artery calcification volume score was observed for the statin group compared to the non-statin group. On echocardiography, statin treatment had no significant impact on aortic valve stenosis. Patients with serum LDL level >130 mg/dl showed less progression of coronary artery calcification when treated with statin drugs. The level of high-sensitivity C-reactive protein (hsCRP) significantly correlated with the progression of calcification for both the aortic valve and coronary arteries.
Conclusion:
Whilst there was no significant benefit of statin treatment on aortic valve calcification over one year, there was a decreased progression of coronary artery calcification. The baseline level of hsCRP was predictive of progression of both aortic valve and coronary artery calcification, and may identify a high-risk population requiring aggressive control, either with statins or emerging drugs targeted at the inflammatory process of atherosclerosis.
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