{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T01:50:46Z","timestamp":1789264246099,"version":"build-2803163510"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"25","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2024,6,18]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Ascending aorta dilation and aortic valve degeneration are common complications in patients with bicuspid aortic valve. Several retrospective studies have suggested the benefit of statins in reducing these complications. This study aimed to determine whether atorvastatin treatment is effective in reducing the growth of aortic diameters in bicuspid aortic valve and if it slows the progression of valve calcification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In a randomized clinical trial, 220 patients with bicuspid aortic valve (43 women; 46\u00b113 years of age) were included and treated with either 20 mg of atorvastatin per day or placebo for 3 years. Inclusion criteria were \u226518 years of age, nonsevere valvular dysfunction, nonsevere valve calcification, and ascending aorta diameter \u226450 mm. Computed tomography and echocardiography studies were performed at baseline and after 3 years of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      During follow-up, 28 patients (12.7%) discontinued medical treatment (15 on atorvastatin and 13 taking placebo). Thus, 192 patients completed the 36 months of treatment. Low-density lipoprotein cholesterol levels decreased significantly in the atorvastatin group (median [interquartile range], \u221230 mg\/dL [\u221251.65 to \u22121.75 mg\/dL] versus 6 mg\/dL [\u22124, 22.5 mg\/dL];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). The maximum ascending aorta diameter increased with no differences between groups: 0.65 mm (95% CI, 0.45\u20130.85) in the atorvastatin group and 0.74 mm (95% CI, 0.45\u20131.04) in the placebo group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.613). Similarly, no significant differences were found for the progression of the aortic valve calcium score (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.167) or valvular dysfunction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Among patients with bicuspid aortic valve without severe valvular dysfunction, atorvastatin treatment was not effective in reducing the progression of ascending aorta dilation and aortic valve calcification during 3 years of treatment despite a significant reduction in low-density lipoprotein cholesterol levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrialsregister.eu\">https:\/\/www.clinicaltrialsregister.eu<\/jats:ext-link>\n                      ; Unique identifier: 2015-001808-57. URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT02679261.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.123.067537","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T15:01:15Z","timestamp":1744210875000},"page":"1938-1948","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Atorvastatin Effect on Aortic Dilatation and Valvular Calcification Progression in Bicuspid Aortic Valve (BICATOR): A Randomized Clinical Trial"],"prefix":"10.1161","volume":"149","clinical-trial-number":[{"clinical-trial-number":"nct02679261","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Arturo","family":"Evangelista","sequence":"first","affiliation":[{"name":"Servei de Cardiologia (A.E., L.G.-G., G.T.-T., A.R.-M., M.A.C., H.C.-C., I.F.-G., J.F.R.-P.), Hospital Universitari Vall d\u00b4Hebron, Barcelona, Spain."},{"name":"CIBER-CV (A.E., A.G., G.T.-T., T.S., J.B., I.M., V.S., J.M.R.-C., E.F., D.S., A.R.-M., J.F.R.-P.), Instituto de Salud Carlos III, Madrid, Spain."},{"name":"Vall d\u2019Hebron Institut de Recerca (VHIR), Barcelona, Spain (A.E., L.G.-G., A.G., G.T.-T., A.R.-M., L.D.-S., A.S.-A., I.F.-G., J.F.R.-P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6828-5928","authenticated-orcid":true,"given":"Laura","family":"Galian-Gay","sequence":"additional","affiliation":[{"name":"Servei de Cardiologia (A.E., L.G.-G., G.T.-T., A.R.-M., M.A.C., 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