Statins for progression of aortic valve stenosis and the best evidence for making decisions in health care
Keywords:
Aortic valve stenosis, Hydroxymethylglutaryl-CoA reductase inhibitors, Atherosclerosis, Disease progression, Review [publication type]Abstract
In the Western world, calcified aortic valve stenosis is the most common form of valvular heart disease, affecting up to 3% of adults over the age of 75 years. It is a gradually progressive disease, characterized by a long asymptomatic phase that may last for several decades, followed by a short symptomatic phase associated with severe restriction of the valve orifice. Investigations on treatments for aortic valve stenosis are still in progress. Thus, it is believed that calcification of aortic valve stenosis is similar to the process of atherosclerosis that occurs in coronary artery disease. Recent studies have suggested that cholesterol lowering through the use of statins may have a salutary effect on the progression of aortic valve stenosis.
Downloads
References
Bonow RO, Carabello BA, Chatterjee K, et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart di- sease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interven- tions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(13):e1-142.
Rajamannan NM. Update on the pathophysiology of aortic stenosis. European Heart Journal Supplements. 2008;10(Suppl E):E4-E10. Available from: http://eurheartjsu- pp.oxfordjournals.org/content/10/suppl_E/E4.short. Accessed in 2010 (Oct 28).
O’Brien KD, Reichenbach DD, Marcovina SM, et al. Apolipoproteins B, (a), and E ac- cumulate in the morphologically early lesion of ‘degenerative’ valvular aortic stenosis. Arterioscler Thromb Vasc Biol. 1996;16(4):523-32.
Chambers JB. Aortic stenosis. Eur J Echocardiogr. 2009;10(1):i11-9.
Braunwald E, Bonow RO. Doença valvular cardíaca. In: Zipes DP, Libby P, Bonow RO, et al, edito- res. Tratado de doenças cardiovasculares. 7a ed. Rio de Janeiro: Elsevier; 2006. p. 1582-92.
Armstrong WF. Ecocardiografia. In: Zipes DP, Libby P, Bonow RO, et al, editores. Tratado de doenças cardiovasculares. 7a ed. Rio de Janeiro: Elsevier; 2006. p. 217-9.
Rajamannan NM. Calcific aortic stenosis: a disease ready for prime time. Circulation. 2006;114(19):2007-9.
Roques F, Nashef SA, Michel P, et al. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg. 1999;15(6):816-22; discussion 822-3.
Culliford AT, Galloway AC, Colvin SB, et al. Aortic valve replacement for aortic stenosis in persons aged 80 years and over. Am J Cardiol. 1991;67(15):1256-60.
Cavaco R, Oliveira S, Clara JG. Estenose aórtica grave: pontos de interesse para o Internista na orientação terapêutica [Severe aortic stenosis: points of interest for the Internist concerning therapeutic orientation]. Revista da Sociedade Portuguesa de Medicina Interna. 2007;14(4):228-35. Available from: http://www.spmi.pt/revista/vol14/vol14_n4_2007_228_235.pdf. Accessed in 2010 (Oct 28).
Antonini-Canterin F, Corrado G, Faggiano P, et al. A medical therapy for aortic valve sclerosis and aortic valve stenosis? Rationale of the ASSIST study (Asymptomatic aortic Sclerosis/Stenosis: Influence of Statins): a large, observational, prospective, multicenter study of the Italian Society of Cardiovascular Echography. J Cardiovasc Med (Hagerstown). 2006;7(7):464-9.
Carabello BA. Evaluation and management of patients with aortic stenosis. Circulation. 2002;105(15):1746-50.
Kapur NK, Musunuru K. Clinical efficacy and safety of statins in managing cardiovascu- lar risk. Vasc Health Risk Manag. 2008;4(2):341-53.
Vaughan CJ, Gotto AM Jr. Update on statins: 2003. Circulation. 2004;110(7):886-92.
Sposito AC, Caramelli B, Fonseca FAH, et al. IV Diretriz Brasileira sobre Dislipidemias e Prevenção da Aterosclerose: Departamento de Aterosclerose da Sociedade Brasileira de Cardiologia. Arq. Bras. Cardiol. 2007,88(supl. 1):2-19.
Schwartz GG, Olsson AG, Ezekowitz MD, et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized con- trolled trial. JAMA. 2001;285(13):1711-8.
Ridker PM, Danielson E, Fonseca FA, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195-207.
Pohle K, Mäffert R, Ropers D, et al. Progression of aortic valve calcification: asso- ciation with coronary atherosclerosis and cardiovascular risk factors. Circulation. 2001;104(16):1927-32.
Novaro GM, Tiong IY, Pearce GL, et al. Effect of hydroxymethylglutaryl coenzyme a reductase inhibitors on the progression of calcific aortic stenosis. Circulation. 2001;104(18):2205-9.
Shavelle DM, Takasu J, Budoff MJ, et al. HMG CoA reductase inhibitor (statin) and aortic valve calcium. Lancet. 2002;359(9312):1125-6.
Aronow WS, Ahn C, Kronzon I, Goldman ME. Association of coronary risk factors and use of statins with progression of mild valvular aortic stenosis in older persons. Am J Cardiol. 2001;88(6):693-5.
Bellamy MF, Pellikka PA, Klarich KW, Tajik AJ, Enriquez-Sarano M. Association of cholesterol levels, hydroxymethylglutaryl coenzyme-A reductase inhibitor treatment, and progression of aortic stenosis in the community. J Am Coll Cardiol. 2002;40(10):1723-30.
Rosenhek R, Rader F, Loho N, et al. Statins but not angiotensin-converting enzyme inhibitors delay progression of aortic stenosis. Circulation. 2004;110(10):1291-5.
Dichtl W, Alber HF, Feuchtner GM, et al. Prognosis and risk factors in patients with asymptomatic aortic stenosis and their modulation by atorvastatin (20 mg). Am J Car- diol. 2008;102(6):743-8.
Moura LM, Ramos SF, Zamonaro JL, et al. Rosuvastatin affecting aortic valve endothelium to slow the progression of aortic stenosis. J Am Coll Cardiol. 2007;49(5):554-61.
Mulrow CD. Rationale for systematic reviews. BMJ. 1994;309(6954):597-9.
Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC. A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts. Treatments for myocardial infarction. JAMA. 1992;268(2):240-8.
Oxman AD, Guyatt GH. The science of reviewing research. Ann N Y Acad Sci. 1993;703:125-33; discussion 133-4.
Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Ver- sion 5.0.2. The Cochrane Collaboration; 2008. Available from: http://www.cochrane.org/training/cochrane-handbook. Accessed in 2010 (Oct 28).