An Investigational Drug on Clinical Outcomes in Patients With Aortic Stenosis (Narrowing of the Major Blood Vessel of the Heart)(MK-0653A-043 AM4)(COMPLETED)

Summary

The purpose of this study is to evaluate whether treatment with an investigational drug as compared to placebo will reduce the risk of major cardiovascular events in patients with aortic stenosis.

Timeline

Start

2001-01

Primary completion

2008-04

Completion

2008-04

Outcome

Missed primary endpoint

registry EZ/Simva 10/40 mg vs Placebo; p = 0.591; Hazard Ratio (HR) 0.960 (95% CI) 0.826 to 1.115 NCT00092677 ↗

Publications

• Background Rossebo AB, Pedersen TR, Boman K, Brudi P, Chambers JB, Egstrup K, Gerdts E, Gohlke-Barwolf C, Holme I, Kesaniemi 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.
• Background Steine K, Rossebo AB, Stugaard M, Pedersen TR. Left ventricular systolic and diastolic function in asymptomatic patients with moderate aortic stenosis. Am J Cardiol. 2008 Oct 1;102(7):897-901. doi: 10.1016/j.amjcard.2008.07.001. Epub 2008 Aug 26.
• Bahlmann E, Gerdts E, Einarsen E, Midtbo H, Pedersen ER, Rossebo A, Willems S, Cramariuc D. Impact of sex-specific thresholds for low flow in assessment of prognosis in concordantly and discordantly graded aortic valve stenosis. Eur Heart J Cardiovasc Imaging. 2025 Jan 31;26(2):280-286. doi: 10.1093/ehjci/jeae272.
• Hadziselimovic E, Greve AM, Sajadieh A, Olsen MH, Kesaniemi YA, Nienaber CA, Ray SG, Rossebo AB, Wachtell K, Nielsen OW. Association of high-sensitivity troponin T with outcomes in asymptomatic non-severe aortic stenosis: a post-hoc substudy of the SEAS trial. EClinicalMedicine. 2023 Feb 28;58:101875. doi: 10.1016/j.eclinm.2023.101875. eCollection 2023 Apr.
• Bahlmann E, Einarsen E, Cramariuc D, Pedersen ER, Rossebo AB, Midtbo H, Willems S, Gerdts E. Prognosis in asymptomatic patients with discordantly graded aortic valve stenosis based on pressure recovery adjusted valve area. Open Heart. 2022 Nov;9(2):e002159. doi: 10.1136/openhrt-2022-002159.
• Hadziselimovic E, Greve AM, Sajadieh A, Olsen MH, Kesaniemi YA, Nienaber CA, Ray SG, Rossebo AB, Willenheimer R, Wachtell K, Nielsen OW. Association of Annual N-Terminal Pro-Brain Natriuretic Peptide Measurements With Clinical Events in Patients With Asymptomatic Nonsevere Aortic Stenosis: A Post Hoc Substudy of the SEAS Trial. JAMA Cardiol. 2022 Apr 1;7(4):435-444. doi: 10.1001/jamacardio.2021.5916.
• Bahlmann E, Einarsen E, Cramariuc D, Midtbo H, Mancusi C, Rossebo A, Willems S, Gerdts E. Low myocardial energetic efficiency is associated with increased mortality in aortic stenosis. Open Heart. 2021 Aug;8(2):e001720. doi: 10.1136/openhrt-2021-001720.
• Einarsen E, Cramariuc D, Bahlmann E, Midtbo H, Chambers JB, Gerdts E. Higher Acceleration/Ejection Time Ratio Predicts Impaired Outcome in Aortic Valve Stenosis. Circ Cardiovasc Imaging. 2021 Jan;14(1):e011467. doi: 10.1161/CIRCIMAGING.120.011467. Epub 2021 Jan 19.
• Greve AM, Bang CN, Boman K, Egstrup K, Kesaniemi YA, Ray S, Pedersen TR, Wachtell K. Relation of Lipid-Lowering Therapy to Need for Aortic Valve Replacement in Patients With Asymptomatic Mild to Moderate Aortic Stenosis. Am J Cardiol. 2019 Dec 1;124(11):1736-1740. doi: 10.1016/j.amjcard.2019.08.037. Epub 2019 Sep 7.
• Gerdts E, Saeed S, Midtbo H, Rossebo A, Chambers JB, Einarsen E, Bahlmann E, Devereux R. Higher left ventricular mass-wall stress-heart rate product and outcome in aortic valve stenosis. Heart. 2019 Nov;105(21):1629-1633. doi: 10.1136/heartjnl-2018-314462. Epub 2019 Jun 1.
• Bahlmann E, Cramariuc D, Saeed S, Chambers JB, Nienaber CA, Kuck KH, Lonnebakken MT, Gerdts E. Low systemic arterial compliance is associated with increased cardiovascular morbidity and mortality in aortic valve stenosis. Heart. 2019 Oct;105(19):1507-1514. doi: 10.1136/heartjnl-2018-314386. Epub 2019 May 15.
• Hodges GW, Bang CN, Forman JL, Olsen MH, Boman K, Ray S, Kesaniemi YA, Eugen-Olsen J, Greve AM, Jeppesen JL, Wachtell K. Effect of simvastatin and ezetimibe on suPAR levels and outcomes. Atherosclerosis. 2018 May;272:129-136. doi: 10.1016/j.atherosclerosis.2018.03.030. Epub 2018 Mar 16.
• Hodges GW, Bang CN, Eugen-Olsen J, Olsen MH, Boman K, Ray S, Kesaniemi AY, Jeppesen JL, Wachtell K. SuPAR predicts postoperative complications and mortality in patients with asymptomatic aortic stenosis. Open Heart. 2018 Jan 13;5(1):e000743. doi: 10.1136/openhrt-2017-000743. eCollection 2018.
• Greve AM, Bang CN, Boman K, Egstrup K, Forman JL, Kesaniemi YA, Ray S, Pedersen TR, Best P, Rajamannan NM, Wachtell K. Effect Modifications of Lipid-Lowering Therapy on Progression of Aortic Stenosis (from the Simvastatin and Ezetimibe in Aortic Stenosis [SEAS] Study). Am J Cardiol. 2018 Mar 15;121(6):739-745. doi: 10.1016/j.amjcard.2017.12.011. Epub 2017 Dec 25.
• Bang CN, Greve AM, Rossebo AB, Ray S, Egstrup K, Boman K, Nienaber C, Okin PM, Devereux RB, Wachtell K. Antihypertensive Treatment With beta-Blockade in Patients With Asymptomatic Aortic Stenosis and Association With Cardiovascular Events. J Am Heart Assoc. 2017 Nov 27;6(12):e006709. doi: 10.1161/JAHA.117.006709.
• Saeed S, Senior R, Chahal NS, Lonnebakken MT, Chambers JB, Bahlmann E, Gerdts E. Lower Transaortic Flow Rate Is Associated With Increased Mortality in Aortic Valve Stenosis. JACC Cardiovasc Imaging. 2017 Aug;10(8):912-920. doi: 10.1016/j.jcmg.2017.05.008.
• Thomassen HK, Cioffi G, Gerdts E, Einarsen E, Midtbo HB, Mancusi C, Cramariuc D. Echocardiographic aortic valve calcification and outcomes in women and men with aortic stenosis. Heart. 2017 Oct;103(20):1619-1624. doi: 10.1136/heartjnl-2016-311040. Epub 2017 Jul 11.
• Lonnebakken MT, De Simone G, Saeed S, Boman K, Rossebo AB, Bahlmann E, Gohlke-Barwolf C, Gerdts E. Impact of stroke volume on cardiovascular risk during progression of aortic valve stenosis. Heart. 2017 Sep;103(18):1443-1448. doi: 10.1136/heartjnl-2016-310917. Epub 2017 Apr 28.
• Bahlmann E, Cramariuc D, Minners J, Lonnebakken MT, Ray S, Gohlke-Baerwolf C, Nienaber CA, Jander N, Seifert R, Chambers JB, Kuck KH, Gerdts E. Small aortic root in aortic valve stenosis: clinical characteristics and prognostic implications. Eur Heart J Cardiovasc Imaging. 2017 Apr 1;18(4):404-412. doi: 10.1093/ehjci/jew159.
• Nielsen OW, Sajadieh A, Sabbah M, Greve AM, Olsen MH, Boman K, Nienaber CA, Kesaniemi YA, Pedersen TR, Willenheimer R, Wachtell K. Assessing Optimal Blood Pressure in Patients With Asymptomatic Aortic Valve Stenosis: The Simvastatin Ezetimibe in Aortic Stenosis Study (SEAS). Circulation. 2016 Aug 9;134(6):455-68. doi: 10.1161/CIRCULATIONAHA.115.021213. Epub 2016 Aug 2.
• Bang CN, Greve AM, La Cour M, Boman K, Gohlke-Barwolf C, Ray S, Pedersen T, Rossebo A, Okin PM, Devereux RB, Wachtell K. Effect of Randomized Lipid Lowering With Simvastatin and Ezetimibe on Cataract Development (from the Simvastatin and Ezetimibe in Aortic Stenosis Study). Am J Cardiol. 2015 Dec 15;116(12):1840-4. doi: 10.1016/j.amjcard.2015.09.026. Epub 2015 Oct 3.
• Gerdts E, Rossebo AB, Pedersen TR, Cioffi G, Lonnebakken MT, Cramariuc D, Rogge BP, Devereux RB. Relation of Left Ventricular Mass to Prognosis in Initially Asymptomatic Mild to Moderate Aortic Valve Stenosis. Circ Cardiovasc Imaging. 2015 Nov;8(11):e003644; discussion e003644. doi: 10.1161/CIRCIMAGING.115.003644.
• Blyme A, Asferg C, Nielsen OW, Sehestedt T, Kesaniemi YA, Gohlke-Barwolf C, Boman K, Willenheimer R, Ray S, Nienaber CA, Rossebo A, Wachtell K, Olsen MH. High sensitivity C reactive protein as a prognostic marker in patients with mild to moderate aortic valve stenosis during lipid-lowering treatment: an SEAS substudy. Open Heart. 2015 Feb 4;2(1):e000152. doi: 10.1136/openhrt-2014-000152. eCollection 2015.
• Greve AM, Bang CN, Berg RM, Egstrup K, Rossebo AB, Boman K, Nienaber CA, Ray S, Gohlke-Baerwolf C, Nielsen OW, Okin PM, Devereux RB, Kober L, Wachtell K. Resting heart rate and risk of adverse cardiovascular outcomes in asymptomatic aortic stenosis: the SEAS study. Int J Cardiol. 2015 Feb 1;180:122-8. doi: 10.1016/j.ijcard.2014.11.181. Epub 2014 Nov 26.
• Cramariuc D, Rogge BP, Lonnebakken MT, Boman K, Bahlmann E, Gohlke-Barwolf C, Chambers JB, Pedersen TR, Gerdts E. Sex differences in cardiovascular outcome during progression of aortic valve stenosis. Heart. 2015 Feb;101(3):209-14. doi: 10.1136/heartjnl-2014-306078. Epub 2014 Oct 9.
• Jander N, Hochholzer W, Kaufmann BA, Bahlmann E, Gerdts E, Boman K, Chambers JB, Nienaber CA, Ray S, Rossebo A, Pedersen TR, Wachtell K, Gohlke-Barwolf C, Neumann FJ, Minners J. Velocity ratio predicts outcomes in patients with low gradient severe aortic stenosis and preserved EF. Heart. 2014 Dec;100(24):1946-53. doi: 10.1136/heartjnl-2014-305763. Epub 2014 Sep 12.
• Greve AM, Dalsgaard M, Bang CN, Egstrup K, Rossebo AB, Boman K, Cramariuc D, Nienaber CA, Ray S, Gohlke-Baerwolf C, Okin PM, Devereux RB, Kober L, Wachtell K. Usefulness of the electrocardiogram in predicting cardiovascular mortality in asymptomatic adults with aortic stenosis (from the Simvastatin and Ezetimibe in Aortic Stenosis Study). Am J Cardiol. 2014 Sep 1;114(5):751-6. doi: 10.1016/j.amjcard.2014.06.006. Epub 2014 Jun 21.
• Greve AM, Dalsgaard M, Bang CN, Egstrup K, Ray S, Boman K, Rossebo AB, Gohlke-Baerwolf C, Devereux RB, Kober L, Wachtell K. Stroke in patients with aortic stenosis: the Simvastatin and Ezetimibe in Aortic Stenosis study. Stroke. 2014 Jul;45(7):1939-46. doi: 10.1161/STROKEAHA.114.005296. Epub 2014 Jun 5.
• Minners J, Gohlke-Baerwolf C, Kaufmann BA, Bahlmann E, Gerdts E, Boman K, Chambers JB, Nienaber CA, Willenheimer R, Wachtell K, Holme I, Pedersen TR, Neumann FJ, Jander N. Adjusting parameters of aortic valve stenosis severity by body size. Heart. 2014 Jul;100(13):1024-30. doi: 10.1136/heartjnl-2013-305225. Epub 2014 Apr 29.
• Bahlmann E, Gerdts E, Cramariuc D, Gohlke-Baerwolf C, Nienaber CA, Wachtell K, Seifert R, Chambers JB, Kuck KH, Ray S. Prognostic value of energy loss index in asymptomatic aortic stenosis. Circulation. 2013 Mar 12;127(10):1149-56. doi: 10.1161/CIRCULATIONAHA.112.078857. Epub 2013 Jan 28.
• Greve AM, Gerdts E, Boman K, Gohlke-Baerwolf C, Rossebo AB, Devereux RB, Kober L, Ray S, Willenheimer R, Wachtell K. Impact of QRS duration and morphology on the risk of sudden cardiac death in asymptomatic patients with aortic stenosis: the SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) Study. J Am Coll Cardiol. 2012 Mar 27;59(13):1142-9. doi: 10.1016/j.jacc.2011.12.020.
• Holme I, Pedersen TR, Boman K, Egstrup K, Gerdts E, Kesaniemi YA, Malbecq W, Ray S, Rossebo AB, Wachtell K, Willenheimer R, Gohlke-Barwolf C. A risk score for predicting mortality in patients with asymptomatic mild to moderate aortic stenosis. Heart. 2012 Mar;98(5):377-83. doi: 10.1136/heartjnl-2011-300475. Epub 2011 Dec 8.
• Greve AM, Boman K, Gohlke-Baerwolf C, Kesaniemi YA, Nienaber C, Ray S, Egstrup K, Rossebo AB, Devereux RB, Kober L, Willenheimer R, Wachtell K. Clinical implications of electrocardiographic left ventricular strain and hypertrophy in asymptomatic patients with aortic stenosis: the Simvastatin and Ezetimibe in Aortic Stenosis study. Circulation. 2012 Jan 17;125(2):346-53. doi: 10.1161/CIRCULATIONAHA.111.049759. Epub 2011 Dec 6.
• Cramariuc D, Cioffi G, Rieck AE, Devereux RB, Staal EM, Ray S, Wachtell K, Gerdts E. Low-flow aortic stenosis in asymptomatic patients: valvular-arterial impedance and systolic function from the SEAS Substudy. JACC Cardiovasc Imaging. 2009 Apr;2(4):390-9. doi: 10.1016/j.jcmg.2008.12.021.
• Peto R, Emberson J, Landray M, Baigent C, Collins R, Clare R, Califf R. Analyses of cancer data from three ezetimibe trials. N Engl J Med. 2008 Sep 25;359(13):1357-66. doi: 10.1056/NEJMsa0806603. Epub 2008 Sep 2.

Drugs

Indications