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. 2022 Apr 25:9:877140.
doi: 10.3389/fcvm.2022.877140. eCollection 2022.

Association Between Lipoprotein(a) and Calcific Aortic Valve Disease: A Systematic Review and Meta-Analysis

Qiyu Liu  1   2 , Yanqiao Yu  1   2 , Ruixi Xi  1 , Jingen Li  3 , Runmin Lai  1 , Tongxin Wang  1   2 , Yixuan Fan  1   2 , Zihao Zhang  1   2 , Hao Xu  1 , Jianqing Ju  1
Affiliations

Association Between Lipoprotein(a) and Calcific Aortic Valve Disease: A Systematic Review and Meta-Analysis

Qiyu Liu et al. Front Cardiovasc Med. .

Abstract

Background: Preliminary studies indicated that enhanced plasma levels of lipoprotein(a) [lp(a)] might link with the risk of calcific aortic valve disease (CAVD), but the clinical association between them remained inconclusive. This systematic review and meta-analysis were aimed to determine this association.

Methods: We comprehensively searched PubMed, Embase, Web of Science, and Scopus databases for studies reporting the incidence of CAVD and their plasma lp(a) concentrations. Pooled risk ratio (RR) and 95% confidence interval (95% CI) were calculated to evaluate the effect of lp(a) on CAVD using the random-effects model. Subgroup analyses by study types, countries, and the level of adjustment were also conducted. Funnel plots, Egger's test and Begg's test were conducted to evaluate the publication bias.

Results: Eight eligible studies with 52,931 participants were included in this systematic review and meta-analysis. Of these, four were cohort studies and four were case-control studies. Five studies were rated as high quality, three as moderate quality. The pooled results showed that plasma lp(a) levels ≥50 mg/dL were associated with a 1.76-fold increased risk of CAVD (RR, 1.76; 95% CI, 1.47-2.11), but lp(a) levels ≥30 mg/dL were not observed to be significantly related with CAVD (RR, 1.28; 95% CI, 0.98-1.68). We performed subgroup analyses by study type, the RRs of cohort studies revealed lp(a) levels ≥50 mg/dL and lp(a) levels ≥30 mg/dL have positive association with CAVD (RR, 1.70; 95% CI, 1.39-2.07; RR 1.38; 95% CI, 1.19-1.61).

Conclusion: High plasma lp(a) levels (≥50 mg/dL) are significantly associated with increased risk of CAVD.

Keywords: aortic valve calcification; aortic valve stenosis; calcific aortic valve disease; lipoprotein(a); systematic review and meta-analysis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of studies.
Figure 2
Figure 2
Forest plot for examining the association between lp(a) ≤ 50 mg/dL and CAVD.
Figure 3
Figure 3
Forest plot for examining the association between lp(a) ≤ 30 mg/dL and CAVD.
See this image and copyright information in PMC

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References

    1. Yadgir S, Johnson CO, Aboyans V, Adebayo OM, Adedoyin RA, Afarideh M, et al. . Global, regional, and national burden of calcific aortic valve and degenerative mitral valve diseases, 1990-2017. Circulation. (2020) 141:1670–80. 10.1161/circulationaha.119.043391 - DOI - PubMed
    1. Lindman BR, Clavel MA, Mathieu P, Iung B, Lancellotti P, Otto CM, et al. . Calcific aortic stenosis. Nat Rev Dis Prim. (2016) 2:16006. 10.1038/nrdp.2016.6 - DOI - PMC - PubMed
    1. Dutta P, Lincoln J. Calcific aortic valve disease: a developmental biology perspective. Curr Cardiol Rep. (2018) 20:21. 10.1007/s11886-018-0968-9 - DOI - PMC - PubMed
    1. Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, III, Gentile F, et al. . 2020 ACC/AHA guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. (2021). 143:e35–71. 10.1161/cir.0000000000000932 - DOI - PubMed
    1. Kraler S, Blaser MC, Aikawa E, Camici GG, Lüscher TF. Calcific aortic valve disease: from molecular and cellular mechanisms to medical therapy. Eur Heart J. (2022) 43:683–97. 10.1093/eurheartj/ehab757 - DOI - PMC - PubMed

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