Evidence-based Case Report : The Use of Statin on Slowing Progression of Mitral

Stenosis Patient with Rheumatic Heart Disease

Pangeran Akbar Syah, Karina Niken Pratiwi, Radityo Prakoso, Oktavia Lilyasari

Abstract
Background: Atrial fibrillation is the most common sustained cardiac arryhtmia in clinical practice,
occurring in 1 2 % of the general population. This incidence is higher in countries with a high
prevalence of rheumatic heart disease. The burden of rheumatic heart disease continues to be a major
contributor morbidity and premature death in a poor and developing countries. In these countries, AF
contributes to significant morbidity and mortality in a relatively young population. In rheumatic heart
disease, the mitral valve is involved in nearly all cases. At present, no medical therapy is known to affect
the progression of rheumatic heart disease. Mitral stenosis can be caused by calcification which
characterized by calcium by lipid deposition in the anular fibrosa of the mitral valve. Therefore, we aim
to see the effect of statin treatment on progression of mitral stenosis in patients with rheumatic heart
disease.
Aim: To determine the effect of statin treatment on slowing progression of mitral stenosis in patient with
rheumatic heart disease.
Methods: The data achieved by history taking, physical examination, and laboratory exam by physician
when patient admitted to RSUD Mataram. Also, a structured Pubmed, Proquest and Cochrane search
was conducted to get the evidence-based. After screening 140 articles on titles and abstract by applying
exclusion and inclusion criteria, one article was considered useful by the author and was appraised
concerning validity, importance and applicability as full texts.
Results: Based on the data of prospective study, the mean rate of MS progression rate, expressed as the
rate of decreased MVA, was significantly lower in statin treated patients (0.027+0.056 vs 0.067+0.082)
with p value < 0.005. Fast MS progression (>0.08 cm2/y) was found less in patients treated with statin (p
= 0.008).
Conclusion: The effect of statin treatment in slowing progression of rheumatic heart disease is assessed
for the first time in this study. The result show a significance slower progression of rheumatic mitral
valve disease in patients treated with statins. However, an RCT study must to conduct as a further prove
for the role of statin in reducing the progression of mitral stenosis in patients with rheumatic heart fever,
we hope by slowing the progression of mitral stenosis, the recurrent of AF will be reduced, and
maintaining sinus rhythm in rheumatic heart disease patient will be easier.