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Atherosclerosis, Degenerative Aortic Stenosis and Statins

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Abstract:

Aortic stenosis is the most common valvular heart disease among adult subjects in western countries. The current treatment for aortic stenosis is aortic valve replacement. The possibility of a medical treatment that can slow the progression of aortic stenosis is very fascinating and statins have been tested to reduce the progression of degenerative aortic stenosis (DAS).

The rationale for statin treatment in DAS has a deep pathophysiological substrate; in fact inflammation and lipid infiltration constitute the same histopathological pattern of both aortic stenosis and atherosclerosis and these two conditions have the same risk factors. Whether retrospective studies have shown some efficacy of statins in halting the progression of DAS, prospective trials have shown controversial results. A recently published large and randomized controlled trial SEAS found that statins have no significant effect on the progression of aortic stenosis, the ASTRONOMER, recently confirmed this data.

The most plausible hypothesis is that coronary artery disease and DAS, have a common pathogenetic background and a distinct evolution due to different factors (mechanical stress, genetic factors, interaction between inflammatory cells and calcification mediators). Thus, treatment with statins is not recommended in patients with valvular aortic stenosis and without conventional indications to lipid-lowering treatment.

Keywords: Aortic stenosis; CAD; CBFA-1; Chlamydia pneumonia; Rosuvastatin; SEAS; atherosclerosis; atorvastatin; co-existing ischemic heart disease; congenital valve disease; degenerative aortic stenosis (DAS); diabetes mellitus; dyslipidemia, hypertension; echocardiogram; ezetimibe; hypercholesterolemia; metalloproteinase; osteopontin; rheumatic disease; simvastatin; statin; tomography

Document Type: Research Article

Publication date: January 1, 2011

More about this publication?
  • Current Drug Targets aims to cover the latest and most outstanding developments on the medicinal chemistry and pharmacology of molecular drug targets e.g. disease specific proteins, receptors, enzymes, genes. Each issue of the journal will be devoted to a single timely topic, with series of in-depth reviews, written by leaders in the field, covering a range of current topics on drug targets. These issues will be organized and led by a guest editor who is a recognized expert in the overall topic. As the discovery, identification, characterisation and validation of novel human drug targets for drug discovery continues to grow; this journal will be essential reading for all pharmaceutical scientists involved in drug discovery and development.
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