Valvular heart diseasePrognosis and Risk Factors in Patients With Asymptomatic Aortic Stenosis and Their Modulation by Atorvastatin (20 mg)
Section snippets
Study population
Of 120 patients consecutively referred to our echocardiography laboratory for the evaluation of asymptomatic calcified aortic stenosis, 50 were enrolled from November 2003 to November 2005 and followed until February 2008. Baseline and follow-up assessments after every 12 months included clinical examination, transthoracic echocardiography, multidetector computed tomography, and the biochemical analysis of blood. Patients aged >18 years with calcific aortic stenosis, mean systolic gradients of
Patients
Of 120 patients screened, 50 were randomized, and 47 were ultimately enrolled in the study (Figure 1). Three patients were excluded from the study (1 patient in the placebo group was diagnosed with gastric cancer 3 months after randomization, 1 patient randomized to placebo was lost during follow-up, and 1 patient stopped medication with atorvastatin because of intolerance without any increase in creatinine kinase or hepatic enzyme levels). Baseline characteristics are listed in Table 1. No
Discussion
The main findings of TASS are as follows: (1) The natural histories of patients with asymptomatic aortic stenosis were poor. (2) In addition to established hemodynamic risk factors, the degree of AVC, systemic inflammation (mirrored by increased plasma CRP levels), and elevated NT-proBNP levels predicted MACEs (the latter only in univariate analysis). (3) Age or the presence of concomitant coronary artery calcium did not significantly influence prognosis. (4) Although limited by small sample
Acknowledgment
The help of Anna Muck throughout the study is greatly appreciated.
References (16)
- et al.
Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines
J Am Coll Cardiol
(2004) - et al.
Malignant natural history of asymptomatic severe aortic stenosis: benefit of aortic valve replacement
Ann Thorac Surg
(2006) - et al.
C-reactive protein is increased in patients with degenerative aortic valvular stenosis
J Am Coll Cardiol
(2001) - et al.
Association of coronary risk factors and use of statins with progression of mild valvular aortic stenosis in older persons
Am J Cardiol
(2001) - et al.
Association of cholesterol level, HMG-CoA reductase inhibitor treatment and progression of aortic stenosis in the community
J Am Coll Cardiol
(2002) - et al.
Rosuvastatin affecting aortic valve endothelium to slow the progression of aortic stenosis
J Am Coll Cardiol
(2007) - et al.
Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly
N Engl J Med
(1999) - et al.
Prospective study of asymptomatic valvular aortic stenosisClinical, echocardiographic and exercise predictors of outcome
Circulation
(1997)
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