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Published on: May 31, 2016

Atherosclerosis, degenerative aortic stenosis and statins

Giuseppina Novo1, Giovanni Fazio, Claudia Visconti

  • 1Division of Cardiovascular Diseases, University of Palermo, Italy. novosav@unipa.it

Current Drug Targets
|September 25, 2010
PubMed

Insights

Statins do not slow the progression of degenerative aortic stenosis (DAS), despite shared risk factors with atherosclerosis. Large trials show no significant effect, making statins not recommended for aortic stenosis without other indications.

Area of Science:

  • Cardiology
  • Valvular Heart Disease
  • Pharmacology

Background:

  • Aortic stenosis is the most prevalent valvular heart disease in Western adults, typically treated with aortic valve replacement.
  • The pathophysiology of degenerative aortic stenosis (DAS) involves inflammation and lipid infiltration, similar to atherosclerosis, suggesting potential benefits of statins.
  • Previous retrospective studies indicated statin efficacy, but prospective trials yielded conflicting results.

Purpose of the Study:

  • To evaluate the efficacy of statins in slowing the progression of degenerative aortic stenosis (DAS).
  • To clarify the role of statins in managing aortic stenosis based on current clinical trial evidence.

Main Methods:

  • Review of retrospective studies and large-scale, randomized controlled trials (RCTs) such as SEAS and ASTRONOMER.
  • Analysis of pathophysiological links between aortic stenosis, atherosclerosis, and lipid metabolism.

Main Results:

  • Large RCTs, including SEAS and ASTRONOMER, found no significant effect of statins on the progression of aortic stenosis.
  • Despite shared risk factors and histopathological patterns with atherosclerosis, DAS and coronary artery disease may evolve differently.

Conclusions:

  • Statins are not recommended for patients with valvular aortic stenosis unless they have conventional indications for lipid-lowering treatment.
  • The common pathogenetic background of coronary artery disease and DAS does not translate to similar treatment responses with statins.

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