Abstract 3365: Rosuvastatin Affecting Aortic Valve Endothelium (RAAVE) To Slow Progression of Aortic Stenosis
Background: Recent retrospective studies support the hypothesis that statins slow the progression of aortic stenosis. The aim of this study was to assess the effect of Rosuvastatin on hemodynamic progression of aortic stenosis by treating patients with aortic stenosis and elevated LDL-cholesterol for 18 months.
Methods: We performed an open-label, prospective study evaluating 121 consecutive patients with asymptomatic moderate to severe aortic stenosis (AVA≥ 1.0 cm2), (mean age 73.7±8.9 years; 57 men and 64 women), treated with and without Rosuvastatin according to the NCEP-ATPIII guidelines. Echocardiographic, serum lipid, and inflammatory markers were measured at baseline and every 6 months for 18 months.
Results: Sixty-one patients (50.4%) with elevated LDL (159.7±33.4 mg/dl), aortic valve velocity (AVV) (3.65±0.64 m/sec) and aortic valve area (AVA) (1.23±0.42 cm2) received Rosuvastatin (20mg/day), and 60 (49.6%) with a normal LDL (118.6±37.4 mg/dl), AVV (3.62±0.61 m/sec), and AVA (1.20±0.35 cm2) received no statin. During a mean follow-up of 73±24 weeks, the change in AVA in the control group was (-0.10±0.09 cm2/yr) versus (-0.05 ±0.12 cm2/yr) in the Rosuvastatin group (p=0.041). The increase in AVV was (0.24±0.30 m/sec/yr) in the control group and (0.04±0.38 m/sec/yr) in the Rosuvastatin group (p=0.007). There was significant improvement in serum lipid and echocardiographic measures of aortic stenosis in the statin group.
Conclusion: Prospective treatment of aortic stenosis with Rosuvastatin by targeting serum LDL slowed the hemodynamic progression of aortic stenosis. This is the first prospective study to demonstrate a positive effect of statin therapy in this disease process.