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. 2020 Mar;17(3):133-140.
doi: 10.11909/j.issn.1671-5411.2020.03.009.

Association of serum lipoprotein(a) level with the severity and prognosis of calcific aortic valve stenosis: a Chinese cohort study

Shuo-Lin Liu  1 , Rynat Rozi  1 , Hui-Wei Shi  1 , Ying Gao  1 , Yuan-Lin Guo  1 , Yi-Da Tang  1 , Jian-Jun Li  1 , Na-Qiong Wu  1
Affiliations

Association of serum lipoprotein(a) level with the severity and prognosis of calcific aortic valve stenosis: a Chinese cohort study

Shuo-Lin Liu et al. J Geriatr Cardiol. 2020 Mar.

Abstract

Background: There was a causal relationship between elevated lipoprotein(a) [Lp(a)] levels and increased risk of calcific aortic valve stenosis (CAVS) in whites and blacks. The present study aimed to investigate whether Lp(a) levels were associated with aortic stenosis (AS) severity and clinical events in Chinese patients.

Methods: Levels of serum Lp(a) were measured in 652 patients with CAVS, whom all underwent baseline echocardiographic examination. The clinical endpoint was defined as a composite of aortic valve replacement (AVR) and cardiac death.

Results: Patients in the tertile 3 of Lp(a) had a higher percentage of severe AS compared with those in the tertile 1 and 2 of Lp(a) (46.2% vs. 33.9%, P = 0.005). Moreover, the top tertile of Lp(a) was an independent predictor of severe AS (OR = 1.78, 95% CI: 1.18-2.66, P = 0.006). However, there was no significant association between tertile 3 of Lp(a) and clinical events (hazard ratio: 0.73; 95% CI: 0.43-1.24; P = 0.239) in the multivariate Cox regression analysis during a mean follow-up time of 3.16 ± 2.74 years.

Conclusions: Elevated Lp(a) level was an independent predictor of severe AS by echocardiography in the Chinese population, but was not associated with the increased risk of AVR and cardiac death, suggesting that Lp(a) levels might be helpful in the risk stratification of patients with CAVS.

Keywords: Aortic stenosis; Calcification; Lipoprotein(a); Prognosis; Severity.

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Figures

Figure 1.
Figure 1.. The flow chart of the current study.
AS: aortic stenosis; AVR: aortic valve replacement; CAVS: calcific aortic valve stenosis.
Figure 2.
Figure 2.. Distribution of Lp(a) levels in the total population.
AS: aortic stenosis; CAVS: calcific aortic valve stenosis; Lp(a): lipoprotein(a); Vpeak: peak aortic valve velocity.
Figure 3.
Figure 3.. The percentages of severe AS according to plasma Lp(a) levels.
AS: aortic valve stenosis; BMI: body mass index; LDL-C: low density lipoprotein-cholesterol; Lp(a): lipoprotein(a).
Figure 4.
Figure 4.. Multivariate Cox regression analysis for AVR and cardiac death.
AS: aortic stenosis; AVR: aortic valve replacement; BMI: body mass index; LDL-C: low density lipoprotein-cholesterol.
Figure 5.
Figure 5.. The event-free Survival analysis according to lipoprotein(a) [Lp(a)] levels for aortic valve replacement and cardiac death.
Lp(a): lipoprotein(a).
See this image and copyright information in PMC

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