Document Detail


The effect of angiotensin-converting enzyme inhibitors and statins on the progression of aortic sclerosis and mortality.
MedLine Citation:
PMID:  22808835     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: Although aortic sclerosis has been associated with an increase in adverse cardiovascular outcomes, no proven therapy has been shown to slow its progression to overt aortic stenosis (AS). Thus, the hypothesis was assessed that treatment with angiotensin-converting enzyme inhibitors (ACE-Is), angiotensin receptor blockers (ARBs) or statins may be associated with an improvement in the clinical outcome of these patients.
METHODS: A total of 4,105 patients with evidence of aortic sclerosis seen on transthoracic echocardiography (defined as thickening or calcification with a mean valve gradient < or = 15 mmHg) was identified. Patients with a sclerotic valve who were treated with ACE-Is/ARBs or statins were followed for a mean period of 1,078 +/- 615 days. After adjustment for the propensity to receive ACE-Is/ARBs or statins, mortality, hemodynamic progression to AS, hospitalization for ischemic heart disease (IHD), and congestive heart failure (CHF) were assessed and related to the medical treatment.
RESULTS: At baseline, patients with aortic sclerosis who were treated with an ACE-I/ARB or a statin suffered significantly more from comorbidities such as IHD, CHF, hypertension, diabetes, and peripheral arterial disease, when compared to subjects with sclerotic valves not treated with these drugs. After adjustment for confounding factors, treatment with statins was associated with a significant reduction in mortality (odds ratio [OR] 0.73, 95% CI 0.56-0.98, p = 0.001), admission for IHD (OR 0.81, 95% CI 0.66-0.99, p = 0.03), admission for CHF (OR 0.68, 95% CI 0.55-0.85, p = 0.01) and progression to AS (OR 0.64, 95% CI 0.42-0.97, p = 0.03). While ACE-I treatment resulted in a significant reduction in admission for IHD (OR 0.80, 95% CI 0.65-0.98, p = 0.03) and CHF (OR 0.76, 95% CI 0.62-0.94, p = 0.01), the beneficial trend towards reduced mortality and delayed progression to AS was not significant.
CONCLUSION: Treatment of this patient population with statins led to a significant reduction in mortality and also slowed the progression to AS--an effect that was not statistically significant with ACE-I treatment.
Authors:
Reza Ardehali; Nicholas J Leeper; Andrew M Wilson; Paul A Heidenreich
Related Documents :
11111815 - Surface treated catheters with ion beam based process for blood access.
10451475 - A comparative study of polyurethane and silicone cuffed-catheters in long-term home tot...
22323895 - Niacin extended-release/simvastatin combination therapy produces larger favorable chang...
17603515 - Use of totally implantable catheters for peripheral blood stem cell apheresis.
25070475 - Safety and retention rate of rufinamide in 300 patients: a single pediatric epilepsy ce...
23490475 - Preservation of condyle and disc in the surgical treatment of type iii temporomandibula...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  21     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-07-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  337-43     Citation Subset:  IM    
Affiliation:
Division of Cardiology, University of California Los Angeles, Los Angeles, CA 90095-1760, USA. rardehali@mednet.ucla.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Natriuretic peptides and long-term mortality in patients with severe aortic stenosis.
Next Document:  Transapical valve-in-valve implantation for regurgitant stented aortic bioprostheses.