Do statins slow the progression of aortic valve stenosis?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether therapy with statins significantly slows the progression of aortic valve stenosis. Altogether 226 papers were found using the reported search, of which twelve represented the best evidence to answer the clinical question. The authors, journal, date, country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The results of the reported studies provided conflicting results. There are twelve studies. Ten retrospective studies and one prospective had been promising with a slower rate of hemodynamic progression in patients taking statins. One retrospective and one randomized controlled trial did not halt the progression of calcific aortic stenosis or induce its regression. The data are discrepant as to whether this effect is related to serum lipid levels or to other effects of statins. While the data are not yet strong enough to change clinical practice, two large randomized controlled trials (ASTRONOMER and SEAS) which have recruited 272 and 1873 patients, respectively, will provide important new evidence in this area in the near future.