The project aims to shed light on the role of Sirtuins, enzymes belonging to the third class of histone deacetylases (class III) involved in epigenetic modifications (deacetylation), focusing mainly on Sirtuin 6 (SIRT6), as a regulator of atherosclerosis and severe aortic valve stenosis through molecular-based and epigenetic studies in human VSMC cells.

Inclusion Criteria:

• Patients with atherosclerosis or calcific aortic stenosis with and without diabetes older than 18 years of either sex;
• Patients without atherosclerosis undergoing surgical procedure for endocarditis;
• Patients who will have signed informed consent

Exclusion Criteria:

• Patients for whom biological material cannot be recovered for study purposes;
• Patients who refuse to participate in the study

The study plans to recruit 100 patients admitted to AOU Federico II Cardiac Surgery in Naples subject to surgical procedure with atherosclerosis and calcific aortic stenosis with and without diabetes over a 36-month period. Patients without atherosclerosis or aortic valve stenosis will be considered as a control population and where possible included in a statistical design paired for age and sex with the study population