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ESC Congress 2003: Lipid-lowering therapy for valve prostheses
September 01, 2003IMPORTANT: This press release accompanies a poster or oral session given at the ESC Congress 2003. Written by the investigator himself/herself, this press release does not necessarily reflect the opinion of the European Society of Cardiology
ESC Congress 2003: In our study we have demonstrated that lipid-lowering drugs (statins) can reduce the process of degeneration of the bioprosthetic aortic valves.
Aortic valve replacement is one of the most often performed cardiac surgery procedures nowadays: 70 people per million of the general population undergo aortic valve replacement in the UK each year, a rate that is fairly common in the developed world.
Two main types of valve prosthesis are available (biological or mechanical). Both have advantages and limitations and the choice is not always easy in the individual patient. In general, mechanical valves have a greater long-term durability and provide a satisfactory hemodynamic function, but they are thrombogenic and require permanent anticoagulation with consequent risk of hemorrhagic complications. In contrast, biological prostheses (porcine valves, pericardial bovine valves) have a low thrombogenicity and usually do not require anticoagulation. This reduces the risk of bleeding. However, bioprosthetic valves have the time-dependent propensity to undergo structural degeneration limiting their durability, often necessitating reoperation after some years, with increased morbidity and mortality. For these reasons in young patients a mechanical prostesis is usually preferred, while bioprostheses are more frequently used in the elderly.
To our knowledge, our study is the first one to provide evidence that treatment with statins is associated with significantly lower degeneration of aortic valve bioprostheses. Since there is no other proven medical therapy able to significantly reduce the degenerative process of bioprosthetic aortic valves, the findings of the present study could influence the choice of the type of aortic valve prosthesis and could ultimately modify the current strategies, with important socio-economic consequences.
Our findings need to be confirmed by a prospective, randomized controlled trial before statins can be routinely used in this group of patients.
Dr Francesco Antonini-Canterin
Ospedale Civile S. Maria degli Angeli, Pordenone,
Italy
European Society of Cardiology (ESC)
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