The effect of statins on valve function and calcification in aortic stenosis: A meta-analysis

- The available evidence shows conflicting results on the effect of statins on aortic valve structure and function.
- There is no scientific evidence justifying the use of statins in patients with aortic stenosis and leaflet calcification.
- Our meta-analysis shows statins have no effect on aortic valve function, calcification and clinical outcomes.
- Potential use of statins in early aortic valve leaflet thickening might show potential benefit.

BackgroundAortic calcification has been shown to share the same risk factors as atherosclerosis which suggested a potential benefit from statins therapy. In view of the existing conflicting results, we aimed to provide objective evidence on the effect of statins in aortic stenosis (AS).Methods and resultsA meta-analysis of eligible studies that used statins in AS was performed. Fourteen studies were identified, 5 randomized controlled trials (RCTs) and 9 observational studies. In the 14 studies as a whole, no significant differences were found in all cause mortality (OR = 0.98, p = 0.91), cardiovascular mortality (OR = 0.80, P = 0.23) or the need for valve replacement (OR = 0.93, p = 0.45) between the statins and the control groups. LDL-cholesterol dropped in the statins groups in both <24 months and ≥24 months follow-up (p < 0.001 for both) but not in controls (p = 0.35 and p = 0.33, respectively). In the <24 months statins group, the annual increase in peak aortic velocity and peak gradient was less (p < 0.0001 and p = 0.004, respectively), but the mean gradient, valve area and calcification score were not different from controls. In the ≥24 months statins group, none of the above parameters was different from controls.ConclusionsDespite the consistent beneficial effect of statins on LDL-cholesterol levels, the available evidence showed no effect on aortic valve structure, function or calcification and no benefit for clinical outcomes.