Drugs for Prevention and Treatment of Aortic Stenosis: How Close Are We?

Can J Cardiol. 2021 Jul;37(7):1016-1026. doi: 10.1016/j.cjca.2021.02.017. Epub 2021 Mar 4.

Abstract

Aortic stenosis is one of the most common cardiovascular diseases in the world. Extensive work on the underlying pathophysiology responsible for calcific aortic valve disease and its progression to aortic stenosis has described a complex process involving inflammation, lipid deposition, mineralisation, and genetic factors such as elevated lipoprotein(a). With the advancement of gene silencing technology and development of novel therapeutic agents, we may now be closer than ever to having medical therapies that prevent, or at least slow the progression of aortic stenosis. In this review, we highlight the pathophysiology and risk factors of calcific aortic valve disease, along with current, potential, and emerging novel medical therapies. We also provide potential explanations for the failure of statin trials and suggest new avenues for research and new randomised trials in this area.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aortic Valve / metabolism
  • Aortic Valve / pathology*
  • Aortic Valve Stenosis* / etiology
  • Aortic Valve Stenosis* / metabolism
  • Aortic Valve Stenosis* / prevention & control
  • Aortic Valve Stenosis* / therapy
  • Calcinosis* / etiology
  • Calcinosis* / metabolism
  • Calcinosis* / prevention & control
  • Calcinosis* / therapy
  • Disease Progression
  • Drugs, Investigational / pharmacology
  • Genetic Therapy / methods
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology
  • Medication Therapy Management / trends*

Substances

  • Drugs, Investigational
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors

Supplementary concepts

  • Aortic Valve, Calcification of