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. 2024 Sep 5;3(10):101264.
doi: 10.1016/j.jacadv.2024.101264. eCollection 2024 Oct.

Lipoprotein(a) Levels in Severe Aortic Stenosis Referred for Transcatheter Aortic Valve Implantation Compared to Controls

Itamar Loewenstein  1 , Daniel Lichtenstein  1 , Ilana Goldiner  2 , Jeremy Ben-Shoshan  1 , Amir Halkin  1 , Maayan Konigstein  1 , Shmuel Banai  1 , Yaron Arbel  1 , Ariel Finkelstein  1 , Arie Steinvil  1
Affiliations

Lipoprotein(a) Levels in Severe Aortic Stenosis Referred for Transcatheter Aortic Valve Implantation Compared to Controls

Itamar Loewenstein et al. JACC Adv. .

Abstract

Background: Limited observational reports link elevated lipoprotein(a) (Lp[a]) levels to aortic stenosis (AS) or to disease progression. Data on large cohorts of verified severe AS patients are lacking.

Objectives: The purpose of the study was to characterize Lp(a) levels of severe AS patients referred to transcatheter aortic valve implantation (TAVI) and compare them to a large cohort of Lp(a) samples derived from the general population.

Methods: Lp(a) levels obtained from frozen serum samples of TAVI patients between 2012 and 2017 were compared to a control group for whom Lp(a) levels were obtained for any reason and stratified by gender. Multivariable binary logistic regression analyses were conducted to investigate associations between younger age at TAVI and an Lp(a) cutoff of 50 mg/dL.

Results: Lp(a) levels of 503 TAVI were compared to 25,343 controls. Patients in the AS group had mildly higher median Lp(a) levels compared to controls (20.5 vs 18.7 mg/dL, P = 0.04). Lp(a) levels in males with severe AS were higher than controls (19.9 vs 16.6 mg/dL, P = 0.04). Females had a nonsignificant difference (22.1 vs 21.3 mg/dL, P = 0.87). In multivariable analysis, an Lp(a) cutoff of above 50 mg/dL was not associated with an earlier age at TAVI (beta: 1.04; 95% CI: 0.42-2.57; P = 0.94).

Conclusions: Median Lp(a) levels were only mildly higher in severe AS patients undergoing TAVI in comparison to a large control group, mainly driven by higher Lp(a) levels in males. Higher Lp(a) levels were not associated with an earlier age at TAVI, rejecting its association with an accelerated disease progression.

Keywords: aortic stenosis; lipoprotein a; transcatheter aortic valve implantation.

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Conflict of interest statement

The funding for the laboratory analysis of Lp(a) and additional lipid panel tests was provided by a grant from 10.13039/100004336Novartis Corporation. Dr Finkelstein reports consultation fees from Medtronic and Edwards Lifesciences. Dr Halkin has received consultation fees from Abbott Laboratories and Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Lipoprotein(a) Level Distributions of the Different Study Populations Lipoprotein(a) showed right-skewed distribution curves in all groups. (A) Lipoprotein(a) levels in females vs males in the entire cohort; (B) lipoprotein(a) levels of patients with severe aortic stenosis vs controls for the entire cohort; (C) lipoprotein(a) levels of males with severe aortic stenosis vs controls; (D) lipoprotein(a) levels of females with severe aortic stenosis vs controls.
Central Illustration
Central Illustration
Rates of Lipoprotein(a) Above 50 mg/dL of Severe Aortic Stenosis Patients and Controls
See this image and copyright information in PMC

References

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