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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
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Elevated lipoprotein(a) in mitral and aortic valve calcification and disease: The Copenhagen General Population Study

Morten Kaltoft1, Per E Sigvardsen2, Shoaib Afzal1

  • 1Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

Atherosclerosis
|December 14, 2021
PubMed

Insights

Elevated lipoprotein(a) is linked to mitral and aortic valve calcification and stenosis. Aortic valve calcification acts as a mediator, explaining 31% of this effect.

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Epidemiology

Background:

  • Elevated lipoprotein(a) is a risk factor for cardiovascular disease.
  • Valve calcification, particularly in the aortic and mitral valves, is a significant contributor to heart valve disease.
  • The causal relationship between lipoprotein(a) and valve calcification requires further investigation.

Purpose of the Study:

  • To investigate the causal association between elevated lipoprotein(a) and mitral and aortic valve calcification.
  • To determine if aortic valve calcification mediates the effect of lipoprotein(a) on aortic valve stenosis.

Main Methods:

  • Utilized data from the Copenhagen General Population Study, including cardiac computed tomography for valve calcification assessment.
  • Analyzed plasma lipoprotein(a) levels and employed genetic instruments to establish causality.
  • Included 12,006 individuals for valve calcification analysis and 85,884 for heart valve disease risk.

Main Results:

  • A 10-fold increase in lipoprotein(a) was associated with higher odds of mitral (OR 1.26) and aortic valve calcification (OR 1.62).
  • Elevated lipoprotein(a) showed a significant association with aortic valve stenosis (HR 1.54), but not mitral valve stenosis (HR 0.93).
  • Genetic variants related to lipoprotein(a) levels were strongly associated with both mitral and aortic valve calcification.

Conclusions:

  • Elevated lipoprotein(a) is causally associated with mitral and aortic valve calcification.
  • Aortic valve calcification mediates approximately 31% of the effect of elevated lipoprotein(a) on aortic valve stenosis.
  • These findings highlight lipoprotein(a) as a key factor in the development of calcific valve disease.
Abstract

Keywords:
Heart valveLp(a)Stenosis

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