Journal Article

A Randomized Trial of Intensive Lipid-Lowering Therapy in Calcific Aortic Stenosis

Reid, John, Bloomfield, Peter, Northridge, David B, Cowell, S. Joanna, Prescott, Robin J, Newby, David E, Boon, Nicholas A

2005

Overview

Calcific aortic stenosis, a relatively common problem in the elderly, has been found to be associated with atherosclerosis and hypercholesterolemia. This study found that, contrary to expectations, intensive lipid-lowering therapy with atorvastatin, which reduced low-density lipoprotein cholesterol levels to a mean of 63±23 mg per deciliter, had no effect on the progression of aortic stenosis (as measured by the aortic-jet velocity) or on aortic-valve calcification (as measured by helical computed tomographic scanning). Intensive lipid-lowering therapy with atorvastatin had no effect on the progression of aortic stenosis or on aortic-valve calcification. In the Western world, calcific aortic stenosis is the most common form of valvular heart disease, and its incidence increases with age such that 3 percent of adults over 75 years of age have aortic stenosis. 1 It is a gradually progressive disease, characterized by a long asymptomatic phase, lasting several decades, followed by a shorter symptomatic phase associated with severe narrowing of the orifice of the aortic valve. Once symptoms occur, the prognosis is poor and surgery is usually mandated. Calcific aortic stenosis is now the leading indication for valve replacement in North America and Europe. However, there are currently . . .

• Publisher: Massachusetts Medical Society
• Subject: Age / Anticholesteremic Agents - administration & dosage / Anticholesteremic Agents - adverse effects / Anticholesteremic Agents - therapeutic use / Aortic Valve - diagnostic imaging / Aortic Valve Stenosis - diagnostic imaging / Aortic Valve Stenosis - drug therapy / Atorvastatin Calcium / Blood Flow Velocity / Calcinosis - drug therapy / Cardiology / Cardiovascular disease / Cholesterol, LDL - blood / Coronary vessels / Disease Progression / Double-Blind Method / Echocardiography, Doppler / Heptanoic Acids - administration & dosage / Heptanoic Acids - adverse effects / Heptanoic Acids - therapeutic use / Humans / Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage / Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects / Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use / Lipids / Pyrroles - administration & dosage / Pyrroles - adverse effects / Pyrroles - therapeutic use / Statins / Treatment Failure