The study evaluated the effects of intensive lipid-lowering therapy with simvastatin and ezetimibe on patients with mild-to-moderate, asymptomatic aortic stenosis. A total of 1873 patients were randomized to receive either 40 mg of simvastatin plus 10 mg of ezetimibe or placebo daily. The primary outcome was a composite of major cardiovascular events, including death from cardiovascular causes, aortic-valve replacement, nonfatal myocardial infarction, hospitalization for unstable angina pectoris, heart failure, coronary-artery bypass grafting, percutaneous coronary intervention, and nonhemorrhagic stroke. During a median follow-up of 52.2 months, the primary outcome occurred in 333 patients (35.3%) in the simvastatin–ezetimibe group and in 355 patients (38.2%) in the placebo group (hazard ratio, 0.96; 95% CI, 0.83 to 1.12; P=0.59). There was no significant difference between the two groups in the secondary outcome of aortic-valve-related events. However, fewer patients had ischemic cardiovascular events in the simvastatin–ezetimibe group (148 patients) than in the placebo group (187 patients) (hazard ratio, 0.78; 95% CI, 0.63 to 0.97; P=0.02). The higher incidence of cancer in the simvastatin–ezetimibe group (11.1% vs. 7.5%) required further exploration. The study concluded that long-term, intensive lipid-lowering therapy with simvastatin and ezetimibe had no overall effect on the course of aortic-valve stenosis but reduced the risk of ischemic cardiovascular events.The study evaluated the effects of intensive lipid-lowering therapy with simvastatin and ezetimibe on patients with mild-to-moderate, asymptomatic aortic stenosis. A total of 1873 patients were randomized to receive either 40 mg of simvastatin plus 10 mg of ezetimibe or placebo daily. The primary outcome was a composite of major cardiovascular events, including death from cardiovascular causes, aortic-valve replacement, nonfatal myocardial infarction, hospitalization for unstable angina pectoris, heart failure, coronary-artery bypass grafting, percutaneous coronary intervention, and nonhemorrhagic stroke. During a median follow-up of 52.2 months, the primary outcome occurred in 333 patients (35.3%) in the simvastatin–ezetimibe group and in 355 patients (38.2%) in the placebo group (hazard ratio, 0.96; 95% CI, 0.83 to 1.12; P=0.59). There was no significant difference between the two groups in the secondary outcome of aortic-valve-related events. However, fewer patients had ischemic cardiovascular events in the simvastatin–ezetimibe group (148 patients) than in the placebo group (187 patients) (hazard ratio, 0.78; 95% CI, 0.63 to 0.97; P=0.02). The higher incidence of cancer in the simvastatin–ezetimibe group (11.1% vs. 7.5%) required further exploration. The study concluded that long-term, intensive lipid-lowering therapy with simvastatin and ezetimibe had no overall effect on the course of aortic-valve stenosis but reduced the risk of ischemic cardiovascular events.