Does statin therapy impact the proximal aortopathy in aortic valve disease?

Abstract

BACKGROUND:

Studies have demonstrated that statin therapy decreases the growth rate of abdominal aneurysms. However, the effect of statin therapy on the proximal aortic disease has not been sufficiently elucidated.

AIM:

We aimed to analyse the association between statin treatment and the severity of proximal aortopathy in patients with aortic valve disease.

DESIGN:

Cross-sectional study.

METHODS:

We prospectively identified 458 patients who were referred for aortic valve surgery from 2008 to 2014. Pre-operative measurement of the proximal aorta was performed by TEE, CT or MRT scan. Data of dyslipidemia treatment was obtained by questionnaire.

RESULTS:

The mean ascending aortic diameter in the whole study population was comparable in patients with vs. without statin therapy (i.e. 42.7 mm vs. 43.6 mm, P = 0.46). Logistic regression analysis showed no significant association between statin therapy and proximal aortopathy ≥ 40 mm in the whole study group (OR = 0.69, P = 0.10). For the BAV sub-group, HDL (OR = 0.54, P = 0.038) and cholesterol levels (OR = 2.00, P = 0.038) were found significantly associated with the proximal aortic disease. In the BAV cohort, the statin users with target HDL levels presented a significantly smaller proximal aortic diameter (40.1 mm vs. 46 mm, P = 0.02).

CONCLUSION:

Pre-operative statin therapy demonstrated no significant association with the expression of proximal aortopathy. However, more than 40% of the statin users presented uncontrolled lipid levels at the time of the study. In the BAV sub-group, the statins users with target HDL levels showed a significantly smaller ascending aorta diameter. Target HDL and cholesterol levels were strongly associated with proximal aortic dilation in BAV patients.

• Authors: T Sequeira Gross, S Naito, N Neumann, J Petersen, T Kuntze, H Reichenspurner, Y von Kodolitsch, E Girdauskas
• Journal: QJM : monthly journal of the Association of Physicians (QJM) Vol. 111 Issue 9 Pg. 623-628 (Sep 01 2018) ISSN: 1460-2393 [Electronic] England
• PMID: 29917097 (Publication Type: Journal Article)

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Lipids

Topics

• Adult
• Aged
• Aged, 80 and over
• Aortic Diseases (complications)
• Aortic Valve (diagnostic imaging)
• Bicuspid Aortic Valve Disease
• Cross-Sectional Studies
• Female
• Heart Defects, Congenital (diagnostic imaging, drug therapy)
• Heart Valve Diseases (diagnostic imaging, drug therapy)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Lipids (blood)
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Preoperative Care
• Prospective Studies
• Severity of Illness Index