The SEAS trial 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 simvastatin 40 mg plus ezetimibe 10 mg daily or a placebo. 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, heart failure, coronary-artery bypass grafting, percutaneous coronary intervention, and nonhemorrhagic stroke. The secondary outcomes included events related to aortic-valve stenosis and ischemic cardiovascular events. Over a median follow-up of 52.2 months, the primary outcome occurred in 35.3% of the simvastatin–ezetimibe group and 38.2% of the placebo group, with no significant difference (hazard ratio 0.96, 95% CI 0.83–1.12, P=0.59). Aortic-valve replacement occurred in 28.3% and 29.9% of the simvastatin–ezetimibe and placebo groups, respectively, with no significant difference (hazard ratio 1.00, 95% CI 0.84–1.18, P=0.97). However, the simvastatin–ezetimibe group had fewer ischemic cardiovascular events (148 vs. 187 patients, hazard ratio 0.78, 95% CI 0.63–0.97, P=0.02), mainly due to fewer coronary-artery bypass grafting procedures. Cancer occurred more frequently in the simvastatin–ezetimibe group (105 vs. 70 patients, P=0.01). The study found that simvastatin and ezetimibe did not reduce the composite outcome of combined aortic-valve events and ischemic events in patients with aortic stenosis. However, the therapy reduced the incidence of ischemic cardiovascular events but not events related to aortic-valve stenosis. The results suggest that intensive lipid-lowering therapy with simvastatin and ezetimibe did not significantly affect the progression of aortic stenosis as seen on echocardiography. The study also found an increased incidence of cancer in the simvastatin–ezetimibe group, which requires further investigation. The findings indicate that long-term, intensive lipid-lowering therapy with simvastatin and ezetimibe had no overall effect on the course of aortic-valve stenosis in patients withThe SEAS trial 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 simvastatin 40 mg plus ezetimibe 10 mg daily or a placebo. 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, heart failure, coronary-artery bypass grafting, percutaneous coronary intervention, and nonhemorrhagic stroke. The secondary outcomes included events related to aortic-valve stenosis and ischemic cardiovascular events. Over a median follow-up of 52.2 months, the primary outcome occurred in 35.3% of the simvastatin–ezetimibe group and 38.2% of the placebo group, with no significant difference (hazard ratio 0.96, 95% CI 0.83–1.12, P=0.59). Aortic-valve replacement occurred in 28.3% and 29.9% of the simvastatin–ezetimibe and placebo groups, respectively, with no significant difference (hazard ratio 1.00, 95% CI 0.84–1.18, P=0.97). However, the simvastatin–ezetimibe group had fewer ischemic cardiovascular events (148 vs. 187 patients, hazard ratio 0.78, 95% CI 0.63–0.97, P=0.02), mainly due to fewer coronary-artery bypass grafting procedures. Cancer occurred more frequently in the simvastatin–ezetimibe group (105 vs. 70 patients, P=0.01). The study found that simvastatin and ezetimibe did not reduce the composite outcome of combined aortic-valve events and ischemic events in patients with aortic stenosis. However, the therapy reduced the incidence of ischemic cardiovascular events but not events related to aortic-valve stenosis. The results suggest that intensive lipid-lowering therapy with simvastatin and ezetimibe did not significantly affect the progression of aortic stenosis as seen on echocardiography. The study also found an increased incidence of cancer in the simvastatin–ezetimibe group, which requires further investigation. The findings indicate that long-term, intensive lipid-lowering therapy with simvastatin and ezetimibe had no overall effect on the course of aortic-valve stenosis in patients with