Without surgery, however, the patients with severe aortic stenosis invariably decline and risks of death are quite high.

FORBES: Breakthrough Heart Valves: How Will Patients Decide?

But there is at least a theoretical reason that Zetia might succeed in aortic stenosis where statins have not.

FORBES: Another Blow For Merck And Schering

"Overall, I'm very pleased with the fact that intense cholesterol lowering reduces coronary events in patients with aortic stenosis, " said Braunwald.

FORBES: Another Blow For Merck And Schering

With FDA approval patients with severe aortic stenosis who could undergo either strategy, or have no intervention, will be facing a difficult decision.

FORBES: Breakthrough Heart Valves: How Will Patients Decide?

For now, this procedure is usually limited to individuals who have a narrowed aortic valve (aortic stenosis) rather than aortic regurgitation and are considered at high-risk for surgical complications.

CNN: Aortic valve regurgitation

In SEAS, Vytorin failed to do better than placebo at treating a heart valve disease called aortic stenosis, but it did reduce the risk of heart attacks, strokes and operations to unclog arteries.

FORBES: Efficacy Questions Still Dog Vytorin

Aortic stenosis afflicts 2% of people over 65.

FORBES: Another Blow For Merck And Schering

The blockbuster cholesterol drug Vytorin failed to improve a rare heart valve condition called aortic stenosis and seemed to increase rates of cancer, a new study says, dealing another blow to the top-selling drug and its makers, Merck and Schering-Plough .

FORBES: Another Blow For Merck And Schering