Statins as cholesterol-lowering therapy did not significantly reduce the progression or severity of aortic valve calcification, while new trials targeting Lp(a) or PCSK9 are showing promising results.
Does lipid-lowering therapy reduce the progression or severity of aortic valve calcification in patients with CAVD?
While statins fail to halt aortic valve calcification, emerging therapies targeting Lp(a) and PCSK9 show promise in reducing the severity of aortic stenosis.
Calcific Aortic Valve Disease (CAVD) is a fibrocalcific disease. Lipoproteins and oxidized phospholipids play a substantial role in CAVD; the level of Lp(a) has been shown to accelerate the progression of valve calcification. Indeed, oxidized phospholipids carried by Lp(a) into the aortic valve stimulate endothelial dysfunction and promote inflammation. Inflammation and growth factors actively promote the synthesis of the extracellular matrix (ECM) and trigger an osteogenic program. The accumulation of ECM proteins promotes lipid adhesion to valve tissue, which could initiate the osteogenic program in interstitial valve cells. Statin treatment has been shown to have the ability to diminish the death rate in subjects with atherosclerotic impediments by decreasing the serum LDL cholesterol levels. However, the use of HMG-CoA inhibitors (statins) as cholesterol-lowering therapy did not significantly reduce the progression or the severity of aortic valve calcification. However, new clinical trials targeting Lp(a) or PCSK9 are showing promising results in reducing the severity of aortic stenosis. In this review, we discuss the implication of lipids in aortic valve calcification and the current findings on the effect of lipid-lowering therapy in aortic stenosis.
Nsaibia et al. (Fri,) conducted a review in Calcific Aortic Valve Disease (CAVD). Lipid-lowering therapy (Statins, Lp(a) or PCSK9 inhibitors) was evaluated. Statins as cholesterol-lowering therapy did not significantly reduce the progression or severity of aortic valve calcification, while new trials targeting Lp(a) or PCSK9 are showing promising results.