Clinical trial NCT00114491: Rosuvastatin Affecting Aortic Valve Endothelium
Official title: Rosuvastatin Affecting Aortic Valve Endothelium - RAAVE
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Atherosclerosis
Hypercholesterolemia
Keywords: Aortic Stenosis
Statins
Hypercholesterolemia
Lead sponsor: Hospital Pedro Hispano
Sponsor class: OTHER
Collaborators: name: Northwestern University
First posted: 2005-06-16
Enrollment: 200
Sex: ALL
Minimum age (years): 50
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: DEFINED_POPULATION
Time perspective: PROSPECTIVE

Brief summary: Recent studies support the hypothesis that aortic stenosis (AS) develops due to atherosclerosis affecting the aortic valve endothelium. The study's aim was to assess Rosuvastatin on the hemodynamic progression and inflammatory markers of AS by treating low-density lipoprotein (LDL) in patients with AS according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) guidelines for one year.

Detailed description: Background: Recent retrospective studies support the hypothesis that statins slow the progression of aortic stenosis. The aim of this study was to assess the effect of Rosuvastatin on hemodynamic progression of aortic stenosis by treating patients with aortic stenosis and elevated LDL-cholesterol for 18 months.

Methods: We performed an open-label, prospective study evaluating 121 consecutive patients with asymptomatic moderate to severe aortic stenosis (AVA≥ 1.0 cm2), (mean age 73.7±8.9 years; 57 men and 64 women), treated with and without Rosuvastatin according to the NCEP-ATPIII guidelines. Echocardiographic, serum lipid, and inflammatory markers were measured at baseline and every 6 months for 18 months.

Eligibility criteria: Inclusion Criteria:

* Asymptomatic AS
* Normal ejection fraction
* Elevated LDL \>130 mg/dl

Exclusion Criteria:

* Echocardiographic evidence of rheumatic mitral valve disease,
* Previous statin therapy,
* Congenital heart disease (bicuspid aortic valve),
* Subaortic obstruction,
* Creatinine ≥ 2,0 mg/dl (to avoid the potential confounder of an elevated serum \[CaP04\]),
* Evidence of liver disease,
* Greater than mild aortic regurgitation and previous aortic valve surgery

Primary outcomes:
Secondary outcomes:
Other outcomes:
Locations:
city: Porto
country: Portugal
facility: Hospital Pedro Hispano
Study officials:
affiliation: Hospital Pedro Hispano
name: Luis M Moura
role: PRINCIPAL_INVESTIGATOR
References:
citation: Rajamannan NM, Subramaniam M, Stock SR, Stone NJ, Springett M, Ignatiev KI, McConnell JP, Singh RJ, Bonow RO, Spelsberg TC. Atorvastatin inhibits calcification and enhances nitric oxide synthase production in the hypercholesterolaemic aortic valve. Heart. 2005 Jun;91(6):806-10. doi: 10.1136/hrt.2003.029785.
citation: Makkena B, Salti H, Subramaniam M, Thennapan S, Bonow RH, Caira F, Bonow RO, Spelsberg TC, Rajamannan NM. Atorvastatin decreases cellular proliferation and bone matrix expression in the hypercholesterolemic mitral valve. J Am Coll Cardiol. 2005 Feb 15;45(4):631-3. doi: 10.1016/j.jacc.2004.11.023. No abstract available.
citation: Rajamannan NM. Is it time for medical therapy for aortic valve disease? Expert Rev Cardiovasc Ther. 2004 Nov;2(6):845-54. doi: 10.1586/14779072.2.6.845.
citation: Rajamannan NM, Edwards WD, Spelsberg TC. Hypercholesterolemic aortic-valve disease. N Engl J Med. 2003 Aug 14;349(7):717-8. doi: 10.1056/NEJMc031360. No abstract available.
citation: Otto CM. Why is aortic sclerosis associated with adverse clinical outcomes? J Am Coll Cardiol. 2004 Jan 21;43(2):176-8. doi: 10.1016/j.jacc.2003.10.027. No abstract available.
citation: Rajamannan NM, Otto CM. Targeted therapy to prevent progression of calcific aortic stenosis. Circulation. 2004 Sep 7;110(10):1180-2. doi: 10.1161/01.CIR.0000140722.85490.EA. No abstract available.
citation: Rajamannan NM, Subramaniam M, Rickard D, Stock SR, Donovan J, Springett M, Orszulak T, Fullerton DA, Tajik AJ, Bonow RO, Spelsberg T. Human aortic valve calcification is associated with an osteoblast phenotype. Circulation. 2003 May 6;107(17):2181-4. doi: 10.1161/01.CIR.0000070591.21548.69. Epub 2003 Apr 28.
citation: Moura LM, Ramos SF, Zamorano JL, Barros IM, Azevedo LF, Rocha-Goncalves F, Rajamannan NM. Rosuvastatin affecting aortic valve endothelium to slow the progression of aortic stenosis. J Am Coll Cardiol. 2007 Feb 6;49(5):554-61. doi: 10.1016/j.jacc.2006.07.072. Epub 2007 Jan 22.