Statins for aortic valve stenosis
Appendices
Appendix 1. Search strategies
CENTRAL
#1MeSH descriptor Aortic Valve Stenosis explode all trees
#2MeSH descriptor Heart Valve Diseases, this term only
#3(aortic near/2 stenos?s)
#4((heart or aortic) near/2 valv* near/2 disease*)
#5(bicuspid near/2 calcification)
#6(tricuspid near/2 calcification)
#7((aortic or valve) near/2 calcification)
#8(bicuspid near/2 valve*)
#9 (tricuspid near/2 valve*)
#10(calcinos?s)
#11(calci* near/3 stenos?s)
#12(#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11)
#13MeSH descriptor Anticholesteremic Agents explode all trees
#14MeSH descriptor Hydroxymethylglutaryl CoA Reductases explode all trees
#15(hydroxymethylglutaryl* near/5 inhibitor*)
#16 (hmg‐coa* near/5 statin*)
#17(hmg‐coa* near/5 inhibit*)
#18(3‐hydroxy‐3‐methylpentanedioic acid)
#19(beta‐hydroxy‐beta‐methylglutarate)
#20(3‐hydroxy‐3‐methylglutaric acid)
#21(statin*)
#22(altoc?r or altoprev or artein or atorvastatin)
#23(baycol or bristacol or "bay w 6228" or "bay w6228")
#24(canef or cerivastatin or certa or compactin or cranoc or crestor or ci‐981 or ci981 or cs‐500 or cs500 or cs‐514 or cs514)
#25(dalvastatin or denan)
#26(elisor or epatostantin or eptastatin* or epistatin or fluindostatin or fluvastatin or gerosim or itavastatin)
#27(lescol or leucol or lipemol or lipitor or lipibec or liplat or lipex or lipobay or lipovas or lipostat or livalo or loc?ol or lodales or lovacol or lovastatin or l‐654969 or l‐644128 or l644128)
#28 (mevastatin or mevastin or mevinolin or mona?olin or methylcompactin or mk‐803 or mk803 or mk‐0803 or mk0803 or msd‐803 or mevacor or mk‐733 or mk733 or meglutol or mevalotin or mevinacor or medostatin or ml‐236b or ml236b or medipo)
#29 (nk‐104 or nk104 or nks‐104 or nks104 or nisvastatin or neolipid)
#30(pravastatin or prareduct or pravachol or pravacol or pravasin* or pitavastatin or pitava or pravachol)
#31(rms‐431 or rms431 or ribar or rivastatin or rosuvastatin or RG‐12561)
#32 (sanaprav or selektine or simvastatin or sinvacor or s?nvinolin or sortis or sq‐31000 or sq31000 sq‐31,000 or sq31,000 or sri‐62320 or sri62320 or s‐4522 or s4522)
#33(tahor or torvast)
#34(vast?n or xu‐62320 or xu62320 or ym‐548 or ym548 or zarator or zenas or zocor? or zd‐4522 or zd4522)
#35(#13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR #20 OR #21 OR #22 OR #23 OR #24 OR #25 OR #26 OR #27 OR #28 OR #29 OR #30 OR #31 OR #32 OR #33 OR #34)
#36(#12 AND #35)
MEDLINE
1. exp Aortic Valve Stenosis/
2. Heart Valve Diseases/
3. (aortic adj2 stenos?s).tw.
4. ((heart or aortic) adj2 valv* adj2 disease*).tw.
5. (bicuspid adj2 calcification).tw.
6. (tricuspid adj2 calcification).tw.
7. ((aortic or valve) adj2 calcification).tw.
8. (bicuspid adj2 valve*).tw.
9. (tricuspid adj2 valve*).tw.
10. calcinos?s.tw.
11. (calci* adj3 stenos?s).tw.
12. or/1‐11
13. exp Anticholesteremic Agents/
14. exp Hydroxymethylglutaryl CoA Reductases/
15. (hydroxymethylglutaryl* adj5 inhibitor*).tw.
16. (hmg‐coa* adj5 statin*).tw.
17. (hmg‐coa* adj5 inhibit*).tw.
18. 3‐hydroxy‐3‐methylpentanedioic acid.tw.
19. beta‐hydroxy‐beta‐methylglutarate.tw.
20. 3‐hydroxy‐3‐methylglutaric acid.tw.
21. statin*.tw.
22. (altoc?r or altoprev or artein or atorvastatin).tw.
23. (baycol or bristacol or "bay w 6228" or "bay w6228").tw.
24. (canef or cerivastatin or certa or compactin or cranoc or crestor or ci‐981 or ci981 or cs‐500 or cs500 or cs‐514 or cs514).tw.
25. (dalvastatin or denan).tw.
26. (elisor or epatostantin or eptastatin* or epistatin or fluindostatin or fluvastatin or gerosim or itavastatin).tw.
27. (lescol or leucol or lipemol or lipitor or lipibec or liplat or lipex or lipobay or lipovas or lipostat or livalo or loc?ol or lodales or lovacol or lovastatin or l‐654969 or l‐644128 or l644128).tw.
28. (mevastatin or mevastin or mevinolin or mona?olin or methylcompactin or mk‐803 or mk803 or mk‐0803 or mk0803 or msd‐803 or mevacor or mk‐733 or mk733 or meglutol or mevalotin or mevinacor or medostatin or ml‐236b or ml236b or medipo).tw.
29. (nk‐104 or nk104 or nks‐104 or nks104 or nisvastatin or neolipid).tw.
30. (pravastatin or prareduct or pravachol or pravacol or pravasin* or pitavastatin or pitava or pravachol).tw.
31. (rms‐431 or rms431 or ribar or rivastatin or rosuvastatin or RG‐12561).tw.
32. (sanaprav or selektine or simvastatin or sinvacor or s?nvinolin or sortis or sq‐31000 or sq31000 sq‐31,000 or sq31,000 or sri‐62320 or sri62320 or s‐4522 or s4522).tw.
33. (tahor or torvast).tw.
34. (vast?n or xu‐62320 or xu62320 or ym‐548 or ym548 or zarator or zenas or zocor? or zd‐4522 or zd4522).tw.
35. or/13‐34
36. 12 and 35
37. randomized controlled trial.pt.
38. controlled clinical trial.pt.
39. randomized.ab.
40. placebo.ab.
41. drug therapy.fs.
42. randomly.ab.
43. trial.ab.
44. groups.ab.
45. 37 or 38 or 39 or 40 or 41 or 42 or 43 or 44
46. exp animals/ not humans.sh.
47. 45 not 46
48. 36 and 47
Embase
1. exp Aortic Valve Stenosis/
2. Heart Valve Diseases/
3. (aortic adj2 stenos?s).tw.
4. ((heart or aortic) adj2 valv* adj2 disease*).tw.
5. (bicuspid adj2 calcification).tw.
6. (tricuspid adj2 calcification).tw.
7. ((aortic or valve) adj2 calcification).tw.
8. (bicuspid adj2 valve*).tw.
9. (tricuspid adj2 valve*).tw.
10. calcinos?s.tw.
11. (calci* adj3 stenos?s).tw.
12. or/1‐11
13. exp Anticholesteremic Agents/
14. exp Hydroxymethylglutaryl CoA Reductases/
15. (hydroxymethylglutaryl* adj5 inhibitor*).tw.
16. (hmg‐coa* adj5 statin*).tw.
17. (hmg‐coa* adj5 inhibit*).tw.
18. 3‐hydroxy‐3‐methylpentanedioic acid.tw.
19. beta‐hydroxy‐beta‐methylglutarate.tw.
20. 3‐hydroxy‐3‐methylglutaric acid.tw.
21. statin*.tw.
22. (altoc?r or altoprev or artein or atorvastatin).tw.
23. (baycol or bristacol or "bay w 6228" or "bay w6228").tw.
24. (canef or cerivastatin or certa or compactin or cranoc or crestor or ci‐981 or ci981 or cs‐500 or cs500 or cs‐514 or cs514).tw.
25. (dalvastatin or denan).tw.
26. (elisor or epatostantin or eptastatin* or epistatin or fluindostatin or fluvastatin or gerosim or itavastatin).tw.
27. (lescol or leucol or lipemol or lipitor or lipibec or liplat or lipex or lipobay or lipovas or lipostat or livalo or loc?ol or lodales or lovacol or lovastatin or l‐654969 or l‐644128 or l644128).tw.
28. (mevastatin or mevastin or mevinolin or mona?olin or methylcompactin or mk‐803 or mk803 or mk‐0803 or mk0803 or msd‐803 or mevacor or mk‐733 or mk733 or meglutol or mevalotin or mevinacor or medostatin or ml‐236b or ml236b or medipo).tw.
29. (nk‐104 or nk104 or nks‐104 or nks104 or nisvastatin or neolipid).tw.
30. (pravastatin or prareduct or pravachol or pravacol or pravasin* or pitavastatin or pitava or pravachol).tw.
31. (rms‐431 or rms431 or ribar or rivastatin or rosuvastatin or RG‐12561).tw.
32. (sanaprav or selektine or simvastatin or sinvacor or s?nvinolin or sortis or sq‐31000 or sq31000 sq‐31,000 or sq31,000 or sri‐62320 or sri62320 or s‐4522 or s4522).tw.
33. (tahor or torvast).tw.
34. (vast?n or xu‐62320 or xu62320 or ym‐548 or ym548 or zarator or zenas or zocor? or zd‐4522 or zd4522).tw.
35. or/13‐34
36. 12 and 35
37. random$.tw.
38. factorial$.tw.
39. crossover$.tw.
40. cross over$.tw.
41. cross‐over$.tw.
42. placebo$.tw.
43. (doubl$ adj blind$).tw.
44. (singl$ adj blind$).tw.
45. assign$.tw.
46. allocat$.tw.
47. volunteer$.tw.
48. crossover procedure/
49. double blind procedure/
50. randomized controlled trial/
51. single blind procedure/
52. 37 or 38 or 39 or 40 or 41 or 42 or 43 or 44 or 45 or 46 or 47 or 48 or 49 or 50 or 51
53. (animal/ or nonhuman/) not human/
54. 52 not 53
55. 36 and 54
Web of Science
# 34 #33 AND #32
# 33 TS =((random* or blind* or allocat* or assign* or trial* or placebo* or crossover* or cross‐over*))
# 32 #31 AND #10
# 31 #30 OR #29 OR #28 OR #27 OR #26 OR #25 OR #24 OR #23 OR #22 OR #21 OR #20 OR #19 OR #18 OR #17 OR #16 OR #15 OR #14 OR #13 OR #12 OR #11
# 30 TS =((vast?n or xu‐62320 or xu62320 or ym‐548 or ym548 or zarator or zenas or zocor? or zd‐4522 or zd4522))
# 29 TS =((tahor or torvast))
# 28 TS =((sanaprav or selektine or simvastatin or sinvacor or s?nvinolin or sortis or sq‐31000 or sq31000 sq‐31,000 or sq31,000 or sri‐62320 or sri62320 or s‐4522 or s4522))
# 27 TS =((rms‐431 or rms431 or ribar or rivastatin or rosuvastatin or RG‐12561))
# 26 TS =((pravastatin or prareduct or pravachol or pravacol or pravasin* or pitavastatin or pitava or pravachol))
# 25 TS =((nk‐104 or nk104 or nks‐104 or nks104 or nisvastatin or neolipid))
# 24 TS =((mevastatin or mevastin or mevinolin or mona?olin or methylcompactin or mk‐803 or mk803 or mk‐0803 or mk0803 or msd‐803 or mevacor or mk‐733 or mk733 or meglutol or mevalotin or mevinacor or medostatin or ml‐236b or ml236b or medipo))
# 23 TS =((lescol or leucol or lipemol or lipitor or lipibec or liplat or lipex or lipobay or lipovas or lipostat or livalo or loc?ol or lodales or lovacol or lovastatin or l‐654969 or l‐644128 or l644128))
# 22 TS =((elisor or epatostantin or eptastatin* or epistatin or fluindostatin or fluvastatin or gerosim or itavastatin))
# 21 TS =((dalvastatin or denan))
# 20 TS =((canef or cerivastatin or certa or compactin or cranoc or crestor or ci‐981 or ci981 or cs‐500 or cs500 or cs‐514 or cs514))
# 19 TS =((baycol or bristacol or "bay w 6228" or "bay w6228"))
# 18 TS =((altoc?r or altoprev or artein or atorvastatin))
# 17 TS =((statin*))
# 16 TS =((3‐hydroxy‐3‐methylglutaric acid))
# 15 TS =((beta‐hydroxy‐beta‐methylglutarate))
# 14 TS =((3‐hydroxy‐3‐methylpentanedioic acid))
# 13 TS =((hmg‐coa* near/5 inhibit*))
# 12 TS =((hmg‐coa* near/5 statin*))
# 11 TS =((hydroxymethylglutaryl* near/5 inhibitor*))
# 10 #9 OR #8 OR #7 OR #6 OR #5 OR #4 OR #3 OR #2 OR #1
# 9 TS =((calci* near/3 stenos?s))
# 8 TS =((calcinos?s))
# 7 TS =((tricuspid near/2 valve*))
# 6 TS =((bicuspid near/2 valve*))
# 5 TS =(((aortic or valve) near/2 calcification))
# 4 TS =((tricuspid near/2 calcification))
# 3 TS =((bicuspid near/2 calcification))
# 2 TS =(((heart or aortic) near/2 valv* near/2 disease*))
# 1 TS=((aortic near/2 stenos?s))
CINAHL
S34 S12 and S33
S33 S13 or S14 or S15 or S16 or S17 or S18 or S19 or S20 or S21 or S22 or S23 or S24 or S25 or S26 or S27 or S28 or S29 or S30 or S31 or S32
S32 (vast?n or xu‐62320 or xu62320 or ym‐548 or ym548 or zarator or zenas or zocor? or zd‐4522 or zd4522)
S31 (tahor or torvast)
S30 (sanaprav or selektine or simvastatin or sinvacor or s?nvinolin or sortis or sq‐31000 or sq31000 sq‐31,000 or sq31,000 or sri‐62320 or sri62320 or s‐4522 or s4522)
S29 (rms‐431 or rms431 or ribar or rivastatin or rosuvastatin or RG‐12561)
S28 (pravastatin or prareduct or pravachol or pravacol or pravasin* or pitavastatin or pitava or pravachol)
S27 (nk‐104 or nk104 or nks‐104 or nks104 or nisvastatin or neolipid)
S26 (mevastatin or mevastin or mevinolin or mona?olin or methylcompactin or mk‐803 or mk803 or mk‐0803 or mk0803 or msd‐803 or mevacor or mk‐733 or mk733 or meglutol or mevalotin or mevinacor or medostatin or ml‐236b or ml236b or medipo)
S25 (lescol or leucol or lipemol or lipitor or lipibec or liplat or lipex or lipobay or lipovas or lipostat or livalo or loc?ol or lodales or lovacol or lovastatin or l‐654969 or l‐644128 or l644128)
S24 (elisor or epatostantin or eptastatin* or epistatin or fluindostatin or fluvastatin or gerosim or itavastatin)
S23 (dalvastatin or denan)
S22 (canef or cerivastatin or certa or compactin or cranoc or crestor or ci‐981 or ci981 or cs‐500 or cs500 or cs‐514 or cs514)
S21 (baycol or bristacol or "bay w 6228" or "bay w6228")
S20 (altoc?r or altoprev or artein or atorvastatin)
S19 (statin*)
S18 (3‐hydroxy‐3‐methylglutaric acid)
S17 (beta‐hydroxy‐beta‐methylglutarate)
S16 (3‐hydroxy‐3‐methylpentanedioic acid)
S15 (hmg‐coa* N5 inhibit*)
S14 (hmg‐coa* N5 statin*)
S13 (hydroxymethylglutaryl* N5 inhibitor*)
S12 S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 or S9 or S10 or S11
S11 (calci* N3 stenos?s)
S10 (calcinos?s)
S9 (tricuspid N2 valve*)
S8 (bicuspid N2 valve*)
S7 ((aortic or valve) N2 calcification)
S6 (tricuspid N2 calcification)
S5 (bicuspid N2 calcification)
S4 ((heart or aortic) N2 valv* N2 disease*)
S3 (aortic N2 stenos?s)
S2 (MH "Heart Valve Diseases")
S1 (MH "Aortic Valve Stenosis+")
LILACS
#1 (mh:"Estenose da Valva Aórtica" OR "Aortic Stenosis" OR "Estenose da Valva Aórtica" OR "Estenosis de la Válvula Aórtica" OR "Aortic Valve Stenosis" OR MH:C14.280.484.150$ OR MH:C14.280.955.249$ OR "Estenose Aórtica") OR (MH:"Heart Valve Diseases" OR "Enfermedades de las Válvulas Cardíacas" OR "Doenças das Valvas Cardíacas" OR "Valvular Heart Diseases" OR "Doenças Valvares do Coração" OR "Doenças Valvares Cardíacas" OR MH:C14.280.484$) OR (TW:aortic stenos$ (436) OR TW:(heart or aortic) valv$ disease$ OR TW:(bicuspid calcification) OR TW:(tricuspid calcification) OR TW:((aortic or valve) calcification) OR TW:(bicuspid valve$) OR tw:(tricuspid valve$) OR TW:calcinos$ OR TW:(calci$ stenos$) )
#2 (MH:Anticolesterêmicos OR MH:"Anticholesteremic Agents" OR "Agentes Anticolesterémicos" OR "Anticholesteremic Agents" OR "Cholesterol Inhibitors" OR "Hypocholesteremic Agents" OR MH:D27.505.519.186.071.202$ OR MH:D27.505.954.557.500.202$ OR "Inibidores do Colesterol" OR "Agentes Hipocolesterêmicos") OR (MH:"Hidroximetilglutaril CoA Redutases" OR "Hydroxymethylglutaryl CoA Reductases" OR "Hidroximetilglutaril CoA Reductasas" OR "Hidroximetilglutaril CoA Redutases" OR "HMG CoA Reductases" OR MH:D08.811.682.047.385.415$) OR (TW:(hydroxymethylglutaryl$ Inhibitor$) OR TW:(hmg‐coa$ statin$) OR TW:(hmg‐coa$ inhibit$) OR TW:3‐hydroxy‐3‐methylpentanedioic acid OR TW:beta‐hydroxy‐beta‐methylglutarate) OR (TW:3‐hydroxy‐3‐methylglutaric acid OR TW:statin$ OR tw:(altoc$ or altoprev or artein or atorvastatin) OR TW:(baycol or bristacol or "bay w 6228" or "bay w6228") OR TW:(canef or cerivastatin or certa or compactin or cranoc or crestor or ci‐981 or ci981 or cs‐500 or cs500 or cs‐514 or cs514) OR TW:(dalvastatin or denan) OR TW:(elisor or epatostantin or eptastatin$ or epistatin or fluindostatin or fluvastatin or gerosim or itavastatin) OR TW:(lescol or leucol or lipemol or lipitor or lipibec or liplat or lipex or lipobay or lipovas or lipostat or livalo or loc$ or lodales or lovacol or lovastatin or l‐654969 or l‐644128 or l644128) OR TW:(mevastatin or mevastin or mevinolin or mona$olin or methylcompactin or mk‐803 or mk803 or mk‐0803 or mk0803 or msd‐803 or mevacor or mk‐733 or mk733 or meglutol or mevalotin or mevinacor or medostatin or ml‐236b or ml236b or medipo) OR tw:(nk‐104 or nk104 or nks‐104 or nks104 or nisvastatin or neolipid) OR tw:(pravastatin or prareduct or pravachol or pravacol or pravasin* or pitavastatin or pitava or pravachol) OR tw:(rms‐431 or rms431 or ribar or rivastatin or rosuvastatin or RG‐12561) OR TW:(sanaprav or selektine or simvastatin or sinvacor or sInvinolin or sortis or sq‐31000 or sq31000 sq‐31,000 or sq31,000 or sri‐62320 or sri62320 or s‐4522 or s4522) OR TW:(tahor or torvast) OR TW:(vast$ or xu‐62320 or xu62320 or ym‐548 or ym548 or zarator or zenas or zocor$ or zd‐4522 or zd4522))
#1 AND #2
(mh:"Estenose da Valva Aórtica" OR "Aortic Stenosis" OR "Estenose da Valva Aórtica" OR "Estenosis de la Válvula Aórtica" OR "Aortic Valve Stenosis" OR MH:C14.280.484.150$ OR MH:C14.280.955.249$ OR "Estenose Aórtica") OR (MH:"Heart Valve Diseases" OR "Enfermedades de las Válvulas Cardíacas" OR "Doenças das Valvas Cardíacas" OR "Valvular Heart Diseases" OR "Doenças Valvares do Coração" OR "Doenças Valvares Cardíacas" OR MH:C14.280.484$) OR (TW:aortic stenos$ (436) OR TW:(heart or aortic) valv$ disease$ OR TW:(bicuspid calcification) OR TW:(tricuspid calcification) OR TW:((aortic or valve) calcification) OR TW:(bicuspid valve$) OR tw:(tricuspid valve$) OR TW:calcinos$ OR TW:(calci$ stenos$) ) AND (MH:Anticolesterêmicos OR MH:"Anticholesteremic Agents" OR "Agentes Anticolesterémicos" OR "Anticholesteremic Agents" OR "Cholesterol Inhibitors" OR "Hypocholesteremic Agents" OR MH:D27.505.519.186.071.202$ OR MH:D27.505.954.557.500.202$ OR "Inibidores do Colesterol" OR "Agentes Hipocolesterêmicos") OR (MH:"Hidroximetilglutaril CoA Redutases" OR "Hydroxymethylglutaryl CoA Reductases" OR "Hidroximetilglutaril CoA Reductasas" OR "Hidroximetilglutaril CoA Redutases" OR "HMG CoA Reductases" OR MH:D08.811.682.047.385.415$) OR (TW:(hydroxymethylglutaryl$ Inhibitor$) OR TW:(hmg‐coa$ statin$) OR TW:(hmg‐coa$ inhibit$) OR TW:3‐hydroxy‐3‐methylpentanedioic acid OR TW:beta‐hydroxy‐beta‐methylglutarate) OR (TW:3‐hydroxy‐3‐methylglutaric acid OR TW:statin$ OR tw:(altoc$ or altoprev or artein or atorvastatin) OR TW:(baycol or bristacol or "bay w 6228" or "bay w6228") OR TW:(canef or cerivastatin or certa or compactin or cranoc or crestor or ci‐981 or ci981 or cs‐500 or cs500 or cs‐514 or cs514) OR TW:(dalvastatin or denan) OR TW:(elisor or epatostantin or eptastatin$ or epistatin or fluindostatin or fluvastatin or gerosim or itavastatin) OR TW:(lescol or leucol or lipemol or lipitor or lipibec or liplat or lipex or lipobay or lipovas or lipostat or livalo or loc$ or lodales or lovacol or lovastatin or l‐654969 or l‐644128 or l644128) OR TW:(mevastatin or mevastin or mevinolin or mona$olin or methylcompactin or mk‐803 or mk803 or mk‐0803 or mk0803 or msd‐803 or mevacor or mk‐733 or mk733 or meglutol or mevalotin or mevinacor or medostatin or ml‐236b or ml236b or medipo) OR tw:(nk‐104 or nk104 or nks‐104 or nks104 or nisvastatin or neolipid) OR tw:(pravastatin or prareduct or pravachol or pravacol or pravasin* or pitavastatin or pitava or pravachol) OR tw:(rms‐431 or rms431 or ribar or rivastatin or rosuvastatin or RG‐12561) OR TW:(sanaprav or selektine or simvastatin or sinvacor or sInvinolin or sortis or sq‐31000 or sq31000 sq‐31,000 or sq31,000 or sri‐62320 or sri62320 or s‐4522 or s4522) OR TW:(tahor or torvast) OR TW:(vast$ or xu‐62320 or xu62320 or ym‐548 or ym548 or zarator or zenas or zocor$ or zd‐4522 or zd4522))
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Comparison 1 Statin versus Placebo, Outcome 1 Mean pressure gradient.
Comparison 1 Statin versus Placebo, Outcome 2 Valve area.
Comparison 1 Statin versus Placebo, Outcome 3 Aortic jet velocity.
Comparison 1 Statin versus Placebo, Outcome 4 Freedom from valve replacement.
Comparison 1 Statin versus Placebo, Outcome 5 Death from cardiovascular cause.
Comparison 1 Statin versus Placebo, Outcome 6 Hospitalisation for any reason.
Comparison 1 Statin versus Placebo, Outcome 7 Severe adverse events.
| Statin versus Placebo for aortic valve stenosis | |||||
| Patient or population: patients with aortic valve stenosis | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | |
| Assumed risk | Corresponding risk | ||||
| Placebo | Statin | ||||
| Mean pressure gradient (mmHg) Better indicated by lower scores. Follow‐up: median 2.4 to 4.5 years | The mean mean pressure gradient in the control groups was | The mean mean pressure gradient in the intervention groups was | MD ‐0.54 (‐1.88 to 0.80) | 1935 | ⊕⊕⊝⊝ |
| Valve area (cm2) Follow‐up: median 2.4‐ to 3.5 years | The mean valve area in the control groups was | The mean valve area in the intervention groups was | MD ‐0.07 (‐0.28 to 0.14) | 127 | ⊕⊕⊝⊝ |
| Aortic jet velocity (m/s) | The mean aortic jet velocity in the control groups was | The mean aortic jet velocity in the intervention groups was | MD ‐0.06 (‐0.26 to 0.14) | 155 | ⊕⊕⊝⊝ |
| Freedom from valve replacement | Study population | RR 0.93 | 2360 | ⊕⊕⊕⊝ | |
| 281 per 1000 | 261 per 1000 | ||||
| Moderate population | |||||
| 222 per 1000 | 206 per 1000 | ||||
| Death from cardiovascular cause | Study population | RR 0.80 | 2297 | ⊕⊕⊝⊝ | |
| 56 per 1000 | 45 per 1000 | ||||
| Moderate population | |||||
| 39 per 1000 | 31 per 1000 | ||||
| Hospitalisation for any reason | 154 per 1000 | 129 per 1000 | RR 0.84 | 155 | ⊕⊝⊝⊝ |
| Adverse events ‐ Muscle pain | Study population | RR 0.91 | 2204 | ⊕⊕⊕⊝ | |
| 168 per 1000 | 153 per 1000 | ||||
| Moderate population | |||||
| 30 per 1000 | 27 per 1000 | ||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | |||||
| GRADE Working Group grades of evidence | |||||
| 1 Downgraded by one due to randomisation and allocation being unclear for Rossebø 2008. | |||||
| Mild Aortic stenosis | Moderate Aortic stenosis | Severe Aortic stenosis | |
| Valve area | 1.5 cm² | 1.0 to 1.5 cm² | < 1.0 cm² |
| Mean pressure gradient | < 20 mmHg | 20 to 39 mmHg | > 40 mmHg |
| Aortic jet velocity | < 2.0 to 2.9 m per second | 3.0 to 3.9 m per second | > 4.0 m per second |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Mean pressure gradient Show forest plot | 2 | 1935 | Mean Difference (IV, Fixed, 95% CI) | ‐0.54 [‐1.88, 0.80] |
| 2 Valve area Show forest plot | 2 | 127 | Mean Difference (IV, Fixed, 95% CI) | ‐0.07 [‐0.28, 0.14] |
| 3 Aortic jet velocity Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 4 Freedom from valve replacement Show forest plot | 4 | 2360 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.93 [0.81, 1.06] |
| 5 Death from cardiovascular cause Show forest plot | 3 | 2297 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.80 [0.56, 1.15] |
| 6 Hospitalisation for any reason Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Subtotals only | |
| 7 Severe adverse events Show forest plot | 4 | Risk Ratio (M‐H, Fixed, 95% CI) | Subtotals only | |
| 7.1 Muscle pain | 3 | 2204 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.91 [0.75, 1.09] |
| 7.2 Hepatic enzymes elevation | 2 | 2109 | Risk Ratio (M‐H, Fixed, 95% CI) | 2.66 [1.24, 5.67] |
| 7.3 Hepatitis | 2 | 2141 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.14 [0.40, 3.25] |
| 7.4 Gastrointestinal condition | 3 | 2296 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.10 [0.96, 1.25] |
| 7.5 Creatine kinase | 2 | 2109 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.75 [0.17, 3.33] |
