Abstract 2655: Correlates Of Aortic Valve Calcification In Aortic Stenosis: Insights From The Astronomer Study
Aortic valve calcification (AVC), a common finding in aortic stenosis (AS), is a predictor of rapid AS progression and increased risk of cardiac events. We evaluated clinical, echocardiographic and biochemical correlates of AVC to gain insight into pathogenesis and to identify potential targets for intervention.
Methods: The ASTRONOMER study (Aortic Stenosis Progression
Observation: Measuring Effects of Rosuvastatin) is a randomized trial to assess cholesterol lowering using rosuvastatin on AS progression in mild to moderate AS. Patients with indication for cholesterol lowering were excluded. Severity of AVC was classified as none, mild, moderate and severe according to published criteria.
Results: 272 patients (167 men, 105 women; mean age 58.1±13.6 years) have been enrolled with peak and mean AV gradients 41±11 and 23±8 mmHg respectively. Patients with none or mild AVC were compared with patients with moderate or severe AVC (Table⇓). ACE-I= angiotensin converting enzyme inhibitor, BAV=bicuspid aortic valve, BP=blood pressure, HDL-C=high-density lipoprotein cholesterol, LDL-C= low-density lipoprotein cholesterol, MAC=mitral annular calcification. Regression analysis showed that AVC was associated with age (p<0.001), male sex (p=0.01), systolic BP (p=0.002), LDL-C (p=0.05), MAC (p=0.01) and tricuspid AV (p=0.001). With adjustment for age, correlates of AVC were male sex with odds ratio (OD) 2.04, p<0.01, systolic BP (OD=1.02, p=0.096), and LDL-C (OD 1.44, p=0.077).
Conclusions: In patients with AS, age and male sex are the main correlates of AVC. After adjusting for age, AVC is not associated with AV morphology but appears to be related to male sex, BP and LDL-C. Thus BP and LDL-C are promising modifiable targets to prevent AVC which in turn should reduce AS progression.