August 31, 2004Circulation
Statins but Not Angiotensin-Converting Enzyme Inhibitors Delay Progression of Aortic Stenosis
Why the study?
Do statins or ACE inhibitors reduce the hemodynamic progression of aortic stenosis in patients with native AS?
Population
211 consecutive patients with native aortic stenosis, mean age 70+/-10 years, 104 females.
Comparison
Statins, ACE inhibitors, or a combination of both. vs Patients not receiving statins or ACE inhibitors.
Design
Cohort
Follow-up
at least 6 months
Authors
Discussion
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Implication
Statins may slow AS progression; hypothesis-generating and should not change practice pending RCTs.
Key Points
- This research aims to determine the impact of statins and ACE inhibitors on the progression of aortic stenosis.
- Examined 211 patients aged 70 with aortic stenosis over 6 months using echocardiograms.
- Compared hemodynamic progression in patients treated with statins, ACEIs, or both.
- Measured peak aortic jet velocity to assess progression rates.
- Statin treatment resulted in a significantly lower progression rate of 0.10 m/s/y compared to 0.39 m/s/y in controls (P<0.0001).
- ACEIs did not significantly affect progression (P=0.29), nor did they enhance the effect when combined with statins (P=0.81).
- Cholesterol levels showed no correlation with hemodynamic progression in either treatment group.
Structured PICO
Do statins or ACE inhibitors reduce the hemodynamic progression of aortic stenosis in patients with native AS?
P
Population
211 consecutive patients with native aortic stenosis (peak velocity >2.5 m/s, normal left ventricular function, no other significant valvular lesion), mean age 70+/-10 years, 104 females.
I
Intervention
Statins, ACE inhibitors, or a combination of both.
C
Comparator
Patients not receiving statins or ACE inhibitors.
O
Outcome
Hemodynamic progression of aortic stenosis (annualized increase in peak aortic jet velocity).surrogate
Statins, but not ACE inhibitors, significantly reduce the hemodynamic progression of mild-to-moderate and severe aortic stenosis.
Cite This Study
Rosenhek et al. (2004) studied this question.