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19-03-2024 | Aortic Valve Stenosis | Original Article

Association between evolocumab use and slow progression of aortic valve stenosis

Authors: Kengo Terasaka, Masaomi Gohbara, Takeru Abe, Tomohiro Yoshii, Yohei Hanajima, Jin Kirigaya, Mutsuo Horii, Shinnosuke Kikuchi, Hidefumi Nakahashi, Kensuke Matsushita, Yugo Minamimoto, Kozo Okada, Yasushi Matsuzawa, Noriaki Iwahashi, Masami Kosuge, Teruyasu Sugano, Toshiaki Ebina, Kiyoshi Hibi

Published in: Heart and Vessels

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Abstract

No medications have been reported to inhibit the progression of aortic valve stenosis (AS). The present study aimed to investigate whether evolocumab use is related to the slow progression of AS evaluated by serial echocardiography. This was a retrospective observational study from 2017 to 2022 at Yokohama City University Medical Center. Patients aged ≥ 18 with moderate AS were included. Exclusion criteria were (1) mild AS; (2) severe AS defined by maximum aortic valve (AV) velocity ≥ 4.0 m/s; and/or (3) no data of annual follow-up echocardiography. The primary endpoint was the association between evolocumab use and annual changes in the maximum AV-velocity or peak AV-pressure gradient (PG). A total of 57 patients were enrolled: 9 patients treated with evolocumab (evolocumab group), and the other 48 patients assigned to a control group. During a median follow-up of 33 months, the cumulative incidence of AS events (a composite of all-cause death, AV intervention, or unplanned hospitalization for heart failure) was 11% in the evolocumab group and 58% in the control group (P = 0.012). Annual change of maximum AV-velocity or peak AV-PG from the baseline to the next year was 0.02 (− 0.18 to 0.22) m/s per year or 0.60 (− 4.20 to 6.44) mmHg per year in the evolocumab group, whereas it was 0.29 (0.04–0.59) m/s per year or 7.61 (1.46–16.48) mmHg per year in the control group (both P < 0.05). Evolocumab use was associated with slow progression of AS and a low incidence of AS events in patients with moderate AS.
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Metadata
Title
Association between evolocumab use and slow progression of aortic valve stenosis
Authors
Kengo Terasaka
Masaomi Gohbara
Takeru Abe
Tomohiro Yoshii
Yohei Hanajima
Jin Kirigaya
Mutsuo Horii
Shinnosuke Kikuchi
Hidefumi Nakahashi
Kensuke Matsushita
Yugo Minamimoto
Kozo Okada
Yasushi Matsuzawa
Noriaki Iwahashi
Masami Kosuge
Teruyasu Sugano
Toshiaki Ebina
Kiyoshi Hibi
Publication date
19-03-2024
Publisher
Springer Japan
Published in
Heart and Vessels
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-024-02386-6