Evolving Insights in the Intersection of Aortic Stenosis and Atherosclerosis

Recent studies indicate shared pathogenic mechanisms between aortic stenosis and atherosclerosis, highlighting potential therapeutic intersections.

Aortic stenosis and atherosclerosis are often considered separate entities, yet they converge at key pathophysiological crossroads. These processes contribute to calcification and tissue degeneration in both the aortic valve and vascular atherosclerotic lesions, complicating the use of therapies developed for one condition when applied to the other.

Renewed attention on lipid metabolism is driving a paradigm shift. Targeting lipid metabolism can potentially slow the progression of these diseases by reducing lipid accumulation and inflammation. Earlier findings suggest that modulating inflammatory signaling also holds promise for managing both aortic stenosis and atherosclerosis, opening avenues for integrated therapeutic strategies.

Despite the proven benefits of statins in coronary artery disease, they fail to halt aortic stenosis progression, as demonstrated in trials such as SALTIRE and SEAS and noted in the 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease, underscoring the need for disease-specific approaches beyond lipid lowering.

Key Takeaways:

• Shared mechanisms in aortic stenosis and atherosclerosis complicate treatment strategies.
• Lipid metabolism and inflammatory pathways are pivotal therapeutic targets.
• Statin therapy has limitations in aortic stenosis, unlike in coronary artery disease.
• Early interventions derived from atherosclerosis insights offer preventive potential in aortic stenosis.