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Sponsors and Collaborators: |
Helsinki University AstraZeneca |
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Information provided by: | Helsinki University |
ClinicalTrials.gov Identifier: | NCT00699452 |
The present study defines a blinded, randomized, placebo-controlled, prospective study, the aim of which is to determine the influence of intensive statin therapy, using rosuvastatin (target dose 20 mg), and effective treatment with AT-1R antagonist, using candesartan (target dose 16 mg) on stenotic aortic valves. We will specifically quantify whether these drugs attenuate the key pathogenic mechanisms of aortic valve stenosis, namely inflammation, fibrosis, elastin degradation, calcification, and neovascularization.
Condition | Intervention | Phase |
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Aortic Valve Stenosis |
Drug: rosuvastatin Drug: candesartan Drug: rosuvastatin and candesartan Drug: placebo |
Phase III |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator), Placebo Control, Parallel Assignment, Safety/Efficacy Study |
Official Title: | The Potential of Rosuvastatin and Candesartan to Retard the Progression of Aortic Stenosis Influences of Medical Therapy to the Atheroinflammatory Process in Stenotic Aortic Valves |
Estimated Enrollment: | 120 |
Study Start Date: | June 2008 |
Estimated Study Completion Date: | December 2013 |
Estimated Primary Completion Date: | December 2011 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Active Comparator
Rosuvastatin 10 mg/d for 2 weeks, then 20 mg/d until surgery (approximately 3 months)
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Drug: rosuvastatin
Rosuvastatin 10 mg/d for 2 weeks, then 20 mg/d until surgery (approximately 3 months)
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2: Active Comparator
Candesartan 8 mg/d for two weeks, then 16 mg/d until valve replacement surgery (approximately 3 months)
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Drug: candesartan
Candesartan 8 mg/d for two weeks, then 16 mg/d until valve replacement surgery (approximately 3 months)
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3: Active Comparator
Combination therapy: Rosuvastatin 10 mg/d for 2 weeks, then 20 mg/d and candesartan 8 mg/d for two weeks, then 16 mg/d until valve replacement surgery (approximately 3 months)
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Drug: rosuvastatin and candesartan
Combination therapy: Rosuvastatin 10 mg/d for 2 weeks, then 20 mg/d and candesartan 8 mg/d for two weeks, then 16 mg/d until valve replacement surgery (approximately 3 months)
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4: Placebo Comparator
Placebo
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Drug: placebo
placebo
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We will include in the study 120 consecutive patients with clinically significant, symptomatic aortic stenosis referred to the Helsinki University Central Hospital for consideration of valve replacement surgery.Patients who can be put on the hospital's normal waiting list for elective angiography (i.e who do not need urgent surgery) and who give their informed consent, will be randomized into four groups to start therapy with rosuvastatin (10 mg/d for 2 weeks, and then 20 mg/d until surgery) or candesartan (8 mg/d for 2 weeks, and then 16 mg/d until surgery), a combined rosuvastatin and candesartan therapy, or placebo. On average, the overall duration of the drug intervention will be 3 months, i.e. the average time in our institution from referral to surgery. In addition, patients (n=50) undergoing aortic valve replacement surgery due to aortic regurgitation caused by dilation of the aortic root will be included. This population consists of both patients with early sclerotic, i.e. pre-stenotic, changes in their aortic valves (n=30) and of patients without any sclerotic or stenotic changes in their aortic valves (n=20). The group with sclerotic changes in their aortic valves (n=30) will be divided into two groups to receive both rosuvastatin (10 mg/d fro 2 wk and thereafter 20 mg/d until surgery) and candesartan (8 mg/d 2 wk, and then 16 mg/d until surgery) (n=15), or placebo + placebo (n=15).The removed aortic valves will be examined utilizing real-time PCR, autoradiography, fluorometry, immunohistochemistry, double immunofluorecence, confocal microscopy, and enzyme immunoassays. With these techniques, several markers of inflammation, calcification, fibrosis, and the amount of lipid accumulation and oxidation of LDL in the valves will be examined.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Other exclusion criteria include the following:
Contact: Markku Kupari, MD, PhD | 358-9-4717-2441 | markku.kupari@hus.fi |
Contact: Satu Helske, MD, PhD | 358-9-681-411 | satu.helske@wri.fi |
Finland | |
Division of Cardiology, Helsinki University Central Hospital | Recruiting |
Helsinki, Finland, 00029 | |
Contact: Markku Kupari, MD, PhD 358-9-4717-2441 markku.kupari@hus.fi | |
Contact: Satu Helske, MD, PhD 358-9-681-411 satu.helske@wri.fi | |
Principal Investigator: Markku Kupari, MD, PhD |
Principal Investigator: | Markku Kupari, MD, PhD | Division of Cardiology, Helsinki University Central Hospital |
Responsible Party: | Division of Cardiology, Helsinki University Central Hospital ( Markku Kupari ) |
Study ID Numbers: | ROCK-AS |
Study First Received: | June 16, 2008 |
Last Updated: | June 17, 2008 |
ClinicalTrials.gov Identifier: | NCT00699452 |
Health Authority: | Finland: National Agency for Medicines |
aortic stenosis valve rosuvastatin candesartan |
Candesartan cilexetil Pathological Conditions, Anatomical Rosuvastatin Heart Diseases Candesartan Disease Progression |
Constriction, Pathologic Aortic valve stenosis Angiotensin II Aortic Valve Stenosis Heart Valve Diseases |
Antimetabolites Molecular Mechanisms of Pharmacological Action Antilipemic Agents Enzyme Inhibitors Cardiovascular Agents Anticholesteremic Agents Antihypertensive Agents |
Hydroxymethylglutaryl-CoA Reductase Inhibitors Pharmacologic Actions Angiotensin II Type 1 Receptor Blockers Therapeutic Uses Cardiovascular Diseases Ventricular Outflow Obstruction |