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RAAVE

Rosuvastatin Affecting Aortic Valve Endothelium to Slow the Progressions of Aortic Stenosis: RAAVE. RAAVE.

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RAAVE

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  1. Rosuvastatin Affecting Aortic Valve Endothelium to Slow the Progressions of Aortic Stenosis: RAAVE RAAVE Luis M. Moura, MD; Sandra F. Ramos, MSc; José L. Zamorano, MD, PhD; Isabel M. Barros, MD; Luis F. Azevedo, MD; Francisco Rocha-Gonçalves, MD, PhD; Nalini M. Rajamannan, MD Published in the Journal of the American College of Cardiology February 6, 2007

  2. RAAVE: Background • Recent retrospective studies support the hypothesis that statins slow the progression of aortic stenosis. • The objective of this study was to test the effect of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (Rosuvastatin) on the progression of moderate to severe aortic stenosis as measured by echocardiography. Moura, et al. JACC 2007; 49(5): 554-61

  3. RAAVE: Study Design 121 patients presenting consecutively with moderate to severe aortic stenosis as defined by an aortic valve area between 1.0 and 1.5cm2 Open-Label. Prospective. Follow-up every 6 months for 18 months Exclusion Criteria: Patients on angiotensin-converting enzyme inhibitors,coronary artery disease as measured by clinical history, echocardiographic evidence of rheumatic mitral valve disease, previous statin therapy, congenital heart disease (bicuspid aortic valve), subaortic obstruction, creatinine > 2.0 mg/dl, active or chronic liver disease, mild aortic regurgitation, and previous aortic valve surgery. Rosuvastatin (LDL > 130mg/dl) n=61 Control Group (LDL < 130mg/dl) n=60 every 6 mos. for 18 mos. • Primary Endpoint: Progression of aortic stenosis • Secondary Endpoint: Improvement in inflammatory (serum) markers and improvement in LDL cholesterol Moura, et al. JACC 2007; 49(5): 554-61

  4. RAAVE: Baseline Characteristics Moura, et al. JACC 2007; 49(5): 554-61

  5. RAAVE: Baseline Characteristics Moura, et al. JACC 2007; 49(5): 554-61

  6. RAAVE: Primary Endpoint (Cont’d) n =61 n = 60 • Data indicate a slowing of progression of aortic valve disease by echocardiography. P=0.007 Peak Aortic Valve Velocity (m/s/yr) Aortic Valve Area (cm2/yr) P=0.041 n = n = n = 60 n =61 Control Treated Moura, et al. JACC 2007; 49(5): 554-61

  7. RAAVE: Secondary Endpoints (cont’d) • Treated patients had lowering of all the serum markers: total cholesterol, LDL cholesterol, triglycerides, hsCRP, IL-6, and sCD40L. Moura, et al. JACC 2007; 49(5): 554-61

  8. RAAVE: Limitations • This was a relatively small prospective trial that did not take into account timing of therapy and characteristics of the valve lesion. Moura, et al. JACC 2007; 49(5): 554-61

  9. RAAVE: Summary • The clinical, epidemiologic, and experimental evidence of this prospective study suggests that aortic valve stenosis progression can be slowed with the treatment of statins. • The RAAVE study also suggests that earlier treatment with statins is more efficacious in the prevention of progression of aortic valve stenosis than late treatment. Moura, et al. JACC 2007; 49(5): 554-61

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