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Revista Uruguaya de Cardiología

On-line version ISSN 1688-0420


TAVELLA, NORBERTO. Estatinas en la estenosis aórtica. Rev.Urug.Cardiol. [online]. 2007, vol.22, n.3, pp.234-242. ISSN 1688-0420.

The possibility of preventing the occurrence and progression of calcified aortic valve disease is extremely important because it is the third cause of cardiovascular disease, it may have a prompt diagnosis and it has a slow progression. Histological studies during the early stages of the disease show lesions very similar to those of atherosclerosis. The biochemical findings are also very similar at this stage, although they tend to provoke valvular calcification and bone formation later on. Two experimental animal models have been developed: a rabbit fed on a rich diet of cholesterol and a mouse with deficit of apoliprotein E. In both cases, histological, biochemical and hemodynamic changes, similar to those provoked by calcified aortic stenosis were observed, and they can be prevented with statins. There are six retrospective studies in humans in which the effects of statins are studied. They demonstrate that the progression of the illness decreases in relation with low levels of LDL cholesterol or with treatment. In these studies, medication was given to those patients who had more risk factors. The prospective study SALTIRE included patients with severe stenosis, and excluded those with high levels of cholesterol or other indications for statins. There were no changes in the progression of the illness related to the treatment. The RAAVE is a prospective but not randomized study. Patients with high levels of LDL cholesterol were treated with statins and its evolution was compared to that of patients with low LDL cholesterol values; a decrease in the progression of the illness was observed in those who received statins. Randomized trials, such as the SEAS, ASTRONOMER, and STOP.AS are ongoing, and their results are expected by the end of 2008. At this moment, it seems probable that the use of statins in patients treated with statins because of other reasons, improve the evolution of calcified aortic valve disease.


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