Several retrospective and nonrandomized studies have indicated that lowering atherogenic
lipoprotein, in particular
low-density lipoprotein cholesterol, may retard the hemodynamic progression of
aortic stenosis (AS). This valvular disease shares pathogenic and pathoanatomic similarities with
atherosclerosis, at least in their early developments. Two randomized placebo-controlled studies researching the effect of lowering
low-density lipoprotein on AS progression and its clinical consequences have been published recently-the Scottish
Aortic Stenosis and
Lipid Lowering Trial, Impact on Regression (SALTIRE) study and the
Simvastatin and
Ezetimibe in
Aortic Stenosis (SEAS) study. Both of these studies had neutral outcomes. The causes for the negative outcome may be that
cholesterol lowering does not influence AS development in a clinically significant way or it may be due to traits in the design of the studies or treatments. Therefore,
statin treatment for prevention of AS progression cannot be ruled out as a future therapeutic option in AS. The outcome of the ongoing
Aortic Stenosis Progression Observation: Measuring Effects of
Rosuvastatin (ASTRONOMER) study, which is examining
lipid lowering as a treatment for AS, is greatly anticipated.