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Lipoprotein(a) is associated with the onset but not the progression of aortic valve calcification( )

AIM: Lipoprotein(a) [Lp(a)] is a potential causal factor in the pathogenesis of aortic valve disease. However, the relationship of Lp(a) with new onset and progression of aortic valve calcium (AVC) has not been studied. The purpose of the study was to assess whether high serum levels of Lp(a) are as...

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Autores principales: Kaiser, Yannick, van der Toorn, Janine E, Singh, Sunny S, Zheng, Kang H, Kavousi, Maryam, Sijbrands, Eric J G, Stroes, Erik S G, Vernooij, Meike W, de Rijke, Yolanda B, Boekholdt, S Matthijs, Bos, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9840475/
https://www.ncbi.nlm.nih.gov/pubmed/35869873
http://dx.doi.org/10.1093/eurheartj/ehac377
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author Kaiser, Yannick
van der Toorn, Janine E
Singh, Sunny S
Zheng, Kang H
Kavousi, Maryam
Sijbrands, Eric J G
Stroes, Erik S G
Vernooij, Meike W
de Rijke, Yolanda B
Boekholdt, S Matthijs
Bos, Daniel
author_facet Kaiser, Yannick
van der Toorn, Janine E
Singh, Sunny S
Zheng, Kang H
Kavousi, Maryam
Sijbrands, Eric J G
Stroes, Erik S G
Vernooij, Meike W
de Rijke, Yolanda B
Boekholdt, S Matthijs
Bos, Daniel
author_sort Kaiser, Yannick
collection PubMed
description AIM: Lipoprotein(a) [Lp(a)] is a potential causal factor in the pathogenesis of aortic valve disease. However, the relationship of Lp(a) with new onset and progression of aortic valve calcium (AVC) has not been studied. The purpose of the study was to assess whether high serum levels of Lp(a) are associated with AVC incidence and progression. METHODS AND RESULTS: A total of 922 individuals from the population-based Rotterdam Study (mean age 66.0±4.2 years, 47.7% men), whose Lp(a) measurements were available, underwent non-enhanced cardiac computed tomography imaging at baseline and after a median follow-up of 14.0 [interquartile range (IQR) 13.9–14.2] years. New-onset AVC was defined as an AVC score >0 on the follow-up scan in the absence of AVC on the first scan. Progression was defined as the absolute difference in AVC score between the baseline and follow-up scan. Logistic and linear regression analyses were performed to evaluate the relationship of Lp(a) with baseline, new onset, and progression of AVC. All analyses were corrected for age, sex, body mass index, smoking, hypertension, dyslipidaemia, and creatinine. AVC progression was analysed conditional on baseline AVC score expressed as restricted cubic splines. Of the 702 individuals without AVC at baseline, 415 (59.1%) developed new-onset AVC on the follow-up scan. In those with baseline AVC, median annual progression was 13.5 (IQR = 5.2–37.8) Agatston units (AU). Lipoprotein(a) concentration was independently associated with baseline AVC [odds ratio (OR) 1.43 for each 50 mg/dL higher Lp(a); 95% confidence interval (CI) 1.15–1.79] and new-onset AVC (OR 1.30 for each 50 mg/dL higher Lp(a); 95% CI 1.02–1.65), but not with AVC progression (β: −71 AU for each 50 mg/dL higher Lp(a); 95% CI −117; 35). Only baseline AVC score was significantly associated with AVC progression (P < 0.001). CONCLUSION: In the population-based Rotterdam Study, Lp(a) is robustly associated with baseline and new-onset AVC but not with AVC progression, suggesting that Lp(a)-lowering interventions may be most effective in pre-calcific stages of aortic valve disease.
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spelling pubmed-98404752023-01-17 Lipoprotein(a) is associated with the onset but not the progression of aortic valve calcification( ) Kaiser, Yannick van der Toorn, Janine E Singh, Sunny S Zheng, Kang H Kavousi, Maryam Sijbrands, Eric J G Stroes, Erik S G Vernooij, Meike W de Rijke, Yolanda B Boekholdt, S Matthijs Bos, Daniel Eur Heart J Clinical Research AIM: Lipoprotein(a) [Lp(a)] is a potential causal factor in the pathogenesis of aortic valve disease. However, the relationship of Lp(a) with new onset and progression of aortic valve calcium (AVC) has not been studied. The purpose of the study was to assess whether high serum levels of Lp(a) are associated with AVC incidence and progression. METHODS AND RESULTS: A total of 922 individuals from the population-based Rotterdam Study (mean age 66.0±4.2 years, 47.7% men), whose Lp(a) measurements were available, underwent non-enhanced cardiac computed tomography imaging at baseline and after a median follow-up of 14.0 [interquartile range (IQR) 13.9–14.2] years. New-onset AVC was defined as an AVC score >0 on the follow-up scan in the absence of AVC on the first scan. Progression was defined as the absolute difference in AVC score between the baseline and follow-up scan. Logistic and linear regression analyses were performed to evaluate the relationship of Lp(a) with baseline, new onset, and progression of AVC. All analyses were corrected for age, sex, body mass index, smoking, hypertension, dyslipidaemia, and creatinine. AVC progression was analysed conditional on baseline AVC score expressed as restricted cubic splines. Of the 702 individuals without AVC at baseline, 415 (59.1%) developed new-onset AVC on the follow-up scan. In those with baseline AVC, median annual progression was 13.5 (IQR = 5.2–37.8) Agatston units (AU). Lipoprotein(a) concentration was independently associated with baseline AVC [odds ratio (OR) 1.43 for each 50 mg/dL higher Lp(a); 95% confidence interval (CI) 1.15–1.79] and new-onset AVC (OR 1.30 for each 50 mg/dL higher Lp(a); 95% CI 1.02–1.65), but not with AVC progression (β: −71 AU for each 50 mg/dL higher Lp(a); 95% CI −117; 35). Only baseline AVC score was significantly associated with AVC progression (P < 0.001). CONCLUSION: In the population-based Rotterdam Study, Lp(a) is robustly associated with baseline and new-onset AVC but not with AVC progression, suggesting that Lp(a)-lowering interventions may be most effective in pre-calcific stages of aortic valve disease. Oxford University Press 2022-07-23 /pmc/articles/PMC9840475/ /pubmed/35869873 http://dx.doi.org/10.1093/eurheartj/ehac377 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research
Kaiser, Yannick
van der Toorn, Janine E
Singh, Sunny S
Zheng, Kang H
Kavousi, Maryam
Sijbrands, Eric J G
Stroes, Erik S G
Vernooij, Meike W
de Rijke, Yolanda B
Boekholdt, S Matthijs
Bos, Daniel
Lipoprotein(a) is associated with the onset but not the progression of aortic valve calcification( )
title Lipoprotein(a) is associated with the onset but not the progression of aortic valve calcification( )
title_full Lipoprotein(a) is associated with the onset but not the progression of aortic valve calcification( )
title_fullStr Lipoprotein(a) is associated with the onset but not the progression of aortic valve calcification( )
title_full_unstemmed Lipoprotein(a) is associated with the onset but not the progression of aortic valve calcification( )
title_short Lipoprotein(a) is associated with the onset but not the progression of aortic valve calcification( )
title_sort lipoprotein(a) is associated with the onset but not the progression of aortic valve calcification( )
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9840475/
https://www.ncbi.nlm.nih.gov/pubmed/35869873
http://dx.doi.org/10.1093/eurheartj/ehac377
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