Abstract 13386: Do Bisphosphonates Slow the Progression of Aortic Stenosis?
Background: Valvular calcification is associated with the development and progression of aortic stenosis (AS). Given the impact of bisphosphonates on calcification, we studied the role of these drugs on the progression of AS.
Methods: Female patients over the age of 60 with aortic valve area (AVA) between 1.0–2.0 cm2 were identified and studied retrospectively. Only those who had follow up echocardiograms were included. Baseline demographics, echocardiography, laboratory and medication data were collected. Primary outcomes were the change in AVA and Valvular gradients (peak/mean) over time. Freedom from aortic valve replacement (AVR) was studied as a secondary outcome. Propensity matching method was applied for the probability of use of bisphosphonates.
Results: Study included 842 patients (mean age of 76 ± 8 years) with a follow up of 5.1 ± 2.4 years. Of these patients, 323 (38%) were on bisphosphonates. Mean EF at baseline was 57 ± 10% with a mean AVA of 1.3± 0.3 cm2 with peak and mean gradients of 29 ± 11 and 16 ± 7 mmHg, respectively (Table 1). Propensity matching was successfully performed for 468 patients. On follow up, there were no differences in progression of AS based on change in AVA or peak/mean gradients. There was a trend towards freedom from AVR in the bisphosphonates group especially after longer treatment (p=0.07) (Figure 1).
Conclusions: Bisphophonates do not seem to have a significant impact on the hemodynamic progression of AS; however a trend for lower likelihood of progressing to AVR is seen over a long time period. Long-term follow-up of patients may be required to determine treatment effect in AS progression studies given the pathophysiology of the disease.
- © 2010 by American Heart Association, Inc.