Bicuspid Aortic Valve Clinical Trial
— BICATOROfficial title:
Evaluating the Effectiveness of Atorvastatin on the Progression of Aortic Dilatation and Valvular Degeneration in Patients With Bicuspid Aortic Valve (BICATOR)
NCT number | NCT02679261 |
Other study ID # | BICATOR |
Secondary ID | |
Status | Completed |
Phase | Phase 3 |
First received | |
Last updated | |
Start date | June 2016 |
Est. completion date | February 2021 |
Verified date | February 2021 |
Source | Hospital Universitari Vall d'Hebron Research Institute |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Bicuspid Aortic Valve (BAV) is the most common congenital heart disease affecting 1-2% of the population. The aortic dilation and aortic valve degeneration are common complications in patients with BAV. Statins have shown a reduction in the expression of metalloproteinases of the extracellular matrix observed in aortic aneurisms. Several retrospective studies have suggested the benefit of the statins to reduce aortic dilation in patients with BAV. Moreover, although statins did not show to be useful in the progression of aortic stenosis, different studies have suggested a higher profit when the valve affection is not severe. The objective of this study is to determine whether atorvastatin is effective at reducing the progression of aortic dilation in patients with BAV.
Status | Completed |
Enrollment | 220 |
Est. completion date | February 2021 |
Est. primary completion date | February 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Patients = 18 years old with BAV confirmed by transthoracic echocardiography (in case of doubts other techniques will be required: transesophageal echocardiography or CT to confirm diagnosis). - Valve dysfunction only moderate: in case of aortic stenosis with average gradient < 30 mmHg and in case of aortic regurgitation a vena contracta < 7 mm or a jet with < 10 mm. - Aortic valve not show severe calcification by transthoracic echocardiography. - Ascending aortic diameter (Valsalva sinus or tubular ascending aorta) = 50 mm. - The patient must give the consent form signed. Exclusion Criteria: - Patients younger than 18. - Patients with uncontrolled hypertension and a history or risk of diabetes mellitus. - Patients who receive statins treatment or other lipid lowering drug or if they have indication to be treated according to the current clinical practice guidelines. - Previous cardiac surgery or any surgery of other segments of the aorta. - Previous aortic dissection and/or aortic coarctation. - NYHA functional class III or IV. - Presence or antecedent of liver failure (transaminase > 2 fold the superior limit of normal levels according to local laboratory), renal failure (creatinine clearance < 30ml/min or creatinine > 2.5mg/dl), myopathy or creatine kinase levels > 5 fold the superior limit of normality, or other gastrointestinal, hematologic or endocrine diseases or any other situation that according to the investigator criteria could affect the study treatment evaluation. - Hypersensitivity, intolerance or contraindication to any component of the study drug or to the contrast used in CT. - Pregnancy, breastfeeding or desire for pregnancy during the study period. A negative pregnancy test (negative gonadotropin) will be required in all fertile women to participate in the study. - Participation in another drug study. |
Country | Name | City | State |
---|---|---|---|
Spain | Hospital Universitari Germans Trias i Pujol | Badalona | Barcelona |
Spain | Hospital Vall d'Hebron | Barcelona | |
Spain | Hospital General Universitario Gregorio Marañón | Madrid | |
Spain | Hospital Universitario 12 de Octubre | Madrid | |
Spain | Hospital Universitario Virgen de la Victoria | Málaga | |
Spain | Hospital Clínico Universitario Virgen de la Arrixaca | Murcia | |
Spain | Hospital Universitari Sant Joan de Reus | Reus | Tarragona |
Spain | Hospital Universitario Virgen de la Macarena | Sevilla | |
Spain | Hospital Clínico Universitario de Valladolid | Valladolid | |
Spain | Hospital Universitario de Vigo | Vigo | Pontevedra |
Lead Sponsor | Collaborator |
---|---|
Hospital Universitari Vall d'Hebron Research Institute |
Spain,
Antonini-Canterin F, Hîrsu M, Popescu BA, Leiballi E, Piazza R, Pavan D, Ginghina C, Nicolosi GL. Stage-related effect of statin treatment on the progression of aortic valve sclerosis and stenosis. Am J Cardiol. 2008 Sep 15;102(6):738-42. doi: 10.1016/j.amjcard.2008.04.056. Epub 2008 Jun 26. — View Citation
Chan KL, Teo K, Dumesnil JG, Ni A, Tam J; ASTRONOMER Investigators. Effect of Lipid lowering with rosuvastatin on progression of aortic stenosis: results of the aortic stenosis progression observation: measuring effects of rosuvastatin (ASTRONOMER) trial. Circulation. 2010 Jan 19;121(2):306-14. doi: 10.1161/CIRCULATIONAHA.109.900027. Epub 2010 Jan 4. — View Citation
Cowell SJ, Newby DE, Prescott RJ, Bloomfield P, Reid J, Northridge DB, Boon NA; Scottish Aortic Stenosis and Lipid Lowering Trial, Impact on Regression (SALTIRE) Investigators. A randomized trial of intensive lipid-lowering therapy in calcific aortic stenosis. N Engl J Med. 2005 Jun 9;352(23):2389-97. — View Citation
Crisby M, Nordin-Fredriksson G, Shah PK, Yano J, Zhu J, Nilsson J. Pravastatin treatment increases collagen content and decreases lipid content, inflammation, metalloproteinases, and cell death in human carotid plaques: implications for plaque stabilization. Circulation. 2001 Feb 20;103(7):926-33. — View Citation
Dichtl W, Alber HF, Feuchtner GM, Hintringer F, Reinthaler M, Bartel T, Süssenbacher A, Grander W, Ulmer H, Pachinger O, Müller S. Prognosis and risk factors in patients with asymptomatic aortic stenosis and their modulation by atorvastatin (20 mg). Am J Cardiol. 2008 Sep 15;102(6):743-8. doi: 10.1016/j.amjcard.2008.04.060. Epub 2008 Jul 2. — View Citation
Goel SS, Tuzcu EM, Agarwal S, Aksoy O, Krishnaswamy A, Griffin BP, Svensson LG, Kapadia SR. Comparison of ascending aortic size in patients with severe bicuspid aortic valve stenosis treated with versus without a statin drug. Am J Cardiol. 2011 Nov 15;108(10):1458-62. doi: 10.1016/j.amjcard.2011.06.071. — View Citation
Jovin IS, Duggal M, Ebisu K, Paek H, Oprea AD, Tranquilli M, Rizzo J, Memet R, Feldman M, Dziura J, Brandt CA, Elefteriades JA. Comparison of the effect on long-term outcomes in patients with thoracic aortic aneurysms of taking versus not taking a statin drug. Am J Cardiol. 2012 Apr 1;109(7):1050-4. doi: 10.1016/j.amjcard.2011.11.038. Epub 2012 Jan 3. — View Citation
McLoughlin D, McGuinness J, Byrne J, Terzo E, Huuskonen V, McAllister H, Black A, Kearney S, Kay E, Hill AD, Dietz HC, Redmond JM. Pravastatin reduces Marfan aortic dilation. Circulation. 2011 Sep 13;124(11 Suppl):S168-73. doi: 10.1161/CIRCULATIONAHA.110.012187. — View Citation
Moura LM, Ramos SF, Zamorano JL, Barros IM, Azevedo LF, Rocha-Gonçalves F, Rajamannan NM. Rosuvastatin affecting aortic valve endothelium to slow the progression of aortic stenosis. J Am Coll Cardiol. 2007 Feb 6;49(5):554-61. Epub 2007 Jan 22. — View Citation
Rossebø AB, Pedersen TR, Boman K, Brudi P, Chambers JB, Egstrup K, Gerdts E, Gohlke-Bärwolf C, Holme I, Kesäniemi YA, Malbecq W, Nienaber CA, Ray S, Skjaerpe T, Wachtell K, Willenheimer R; SEAS Investigators. Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis. N Engl J Med. 2008 Sep 25;359(13):1343-56. doi: 10.1056/NEJMoa0804602. Epub 2008 Sep 2. — View Citation
Schouten O, van Laanen JH, Boersma E, Vidakovic R, Feringa HH, Dunkelgrün M, Bax JJ, Koning J, van Urk H, Poldermans D. Statins are associated with a reduced infrarenal abdominal aortic aneurysm growth. Eur J Vasc Endovasc Surg. 2006 Jul;32(1):21-6. Epub 2006 Mar 6. — View Citation
Stein LH, Berger J, Tranquilli M, Elefteraides JA. Effect of statin drugs on thoracic aortic aneurysms. Am J Cardiol. 2013 Oct 15;112(8):1240-5. doi: 10.1016/j.amjcard.2013.05.081. — View Citation
Sukhija R, Aronow WS, Sandhu R, Kakar P, Babu S. Mortality and size of abdominal aortic aneurysm at long-term follow-up of patients not treated surgically and treated with and without statins. Am J Cardiol. 2006 Jan 15;97(2):279-80. Epub 2005 Nov 21. — View Citation
* Note: There are 13 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change of the diameter of ascending aorta by CT (Computed Tomography). | Determination of the progression of ascending aortic dilation assessed by measuring the change of the diameter of ascending aorta by CT (Computed Tomography).The change of the aortic diameter will be defined by the major difference between the measurements taken in the aortic root and ascending aorta in the initial and final study. | 3 years | |
Secondary | Change of the final maximum diameter of the aortic root and the basal measured by CT. | Difference between the final maximum diameter of the aortic root and the basal measured by CT. | 3 years | |
Secondary | Change of the final maximum diameter of the tubular ascending aorta and the basal measured by CT. | Difference between the final maximum diameter of the tubular ascending aorta and the basal measured by CT. | 3 years | |
Secondary | Change of the final area of the aortic root and the basal measured by CT. | Difference between the final area of the aortic root and the basal measured by CT. | 3 years | |
Secondary | Change of the the final area of ascending aorta and the basal measured by CT. | Difference between the final area of ascending aorta and the basal measured by CT. | 3 years | |
Secondary | Change of the valve Agatston final score and the basal assessed by CT. | Difference between the valve Agatston final score and the basal assessed by CT. | 3 years | |
Secondary | Change of the final planimetry area of the aortic valve and the basal measured by CT. | Difference between the final planimetry area of the aortic valve and the basal measured by CT. | 3 years | |
Secondary | Change of the transvalvular pressure gradient of the aortic valve | Difference of transvalvular pressure gradient of the aortic valve | 3 years | |
Secondary | Change of aortic regurgitation jet width basal and final. | Difference of aortic regurgitation jet width basal and final. | 3 years | |
Secondary | Change of the maximum aortic velocity | Change of the maximum aortic velocity | 3 years | |
Secondary | Change of aortic valve area | Change of aortic valve area by continuity equation basal and final | 3 years | |
Secondary | Ocurrence of Serious Adverse Clinical Events leading to hospitalization and death | Serious Adverse Clinical Events: Aortic dissection, aortic rupture or need for aortic surgery, cardiovascular death, death of any cause. Combined endpoint of death, aortic dissection or need for aortic or valve surgery. | 3 years |
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT01390181 -
The Effect of Losartan in Bicuspid Aortic Valve Patients
|
N/A | |
Enrolling by invitation |
NCT06212050 -
Feasibility, Safety, and Effectiveness of the ACURATE neo2 Transcatheter Heart Valve for Severe Bicuspid Aortic Stenosis
|
||
Active, not recruiting |
NCT03635424 -
Medtronic Transcatheter Aortic Valve Replacement (TAVR) Low Risk Bicuspid Study
|
N/A | |
Recruiting |
NCT06153407 -
Genetic Test Based Risk Prediction of Early Calcific Aortic Valve Disease in Patients With Bicuspid Aortic Valve
|
||
Active, not recruiting |
NCT03474159 -
Evaluation of Aortic Stiffness as a Prognostic Indicator of Aortic Dilatation in Patients With Bicuspid Aortic Valve by Multimodal Imaging
|
N/A | |
Not yet recruiting |
NCT06375590 -
NavIIcusp: Bicuspid Aortic Valve Stenosis With Navitor Platform International Experience
|
||
Recruiting |
NCT05739253 -
Changes of Ascending Aortic Diameter in Patients Undergoing Transcatheter Aortic Valve Replacement
|
||
Completed |
NCT01823432 -
Genetic Risks for Bicuspid Aortic Valve Disease
|
||
Completed |
NCT01920815 -
Bicuspid Valve Aortopathy Feasibility Study
|
||
Recruiting |
NCT04817735 -
The CASPER Registry
|
N/A | |
Recruiting |
NCT02899624 -
Whole Exome Sequencing in Bicuspid Aortic Valve Patients
|
N/A | |
Recruiting |
NCT05708118 -
Progression of Ascending Aorta Diameters in Bicuspid Aortic Valve After Transcatheter or Surgical Replacement.
|
||
Recruiting |
NCT03495050 -
BIVOLUTX: Bicuspid Aortic Stenosis With Evolut Platform International Experience.
|
||
Completed |
NCT01760668 -
Aortopathy in Persons With Bicuspid Aortic Valve, Turner and Marfan Syndrome
|
N/A | |
Not yet recruiting |
NCT05711693 -
Measurement of Heart-carotid Pulse Wave Velocity (hcPWV) by Laser Doppler Vibrometry (LDV)
|
N/A | |
Completed |
NCT05836363 -
Fate at Long-term of Mild to Moderate Bicuspid Aortic Valve Disease Left Untreated at the Time of Supracoronary Ascending Aorta Replacement
|
||
Completed |
NCT02283970 -
Investigation of Patients With BAV Requiring Valve and/or Aortic Repair (GISSI Outliers VAR)
|
||
Active, not recruiting |
NCT01026571 -
Identification of Genetic Causes of Bicuspid Aortic Valve Disease
|
||
Completed |
NCT00412386 -
Abnormal 3-D MRI Flow Patterns in Adolescents Patients With Bicuspid Aortic Valve
|
N/A | |
Recruiting |
NCT03440697 -
Pathogenetic Basis of Aortopathy and Aortic Valve Disease
|