Archief Roodbont

The pleiotropic anti-inflammatory properties of statins are believed to bring about the slowing in progression of calcific aortic stenosis seen in some previous studies (but not in all; see JW Cardiol Jul 15 2005). In this observational study, investigators examined the effect of statin therapy on the progression of rheumatic mitral stenosis (MS).

The study population consisted of 315 patients with rheumatic MS (mean age, 61 years; 71% women), of whom 35 (11%) were taking statins, and 280 (89%) were not. Baseline echocardiographic characteristics, including mitral valve area (MVA) and degree of mitral regurgitation, were similar in both groups. After a mean follow-up of 6.1 years, the annualized decrease in mean MVA was significantly smaller in statin-treated patients than in non–statin-treated patients (0.027 vs. 0.067 cm²; P=0.005). In a multivariable analysis, statin treatment independently predicted slower MS progression.

Comment: This is the first study to examine the effect of statin therapy on progression of rheumatic MS. Given the high prevalence of rheumatic disease in many parts of the world, even the small decrease in disease progression that was demonstrated in this study could have important public health implications. These findings support the need for a randomized trial of statin therapy for the prevention of valvular stenosis in patients with rheumatic heart disease.

— Howard C. Herrmann, MD

Published in Journal Watch Cardiology July 14, 2010