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Lipoprotein(a) and Its Autoantibodies in Association with Calcific Aortic Valve Stenosis

Anna L Burdeynaya1, Olga I Afanasieva2, Marat V Ezhov1

  • 1Laboratory of Lipid Disorders, Department of Atherosclerosis, A.L. Myasnikov Institute of Clinical Cardiology, Federal State Budgetary Institution National Medical Research Center of Cardiology Named after Academician E.I. Chazov, Ministry of Health of the Russian Federation, 121552 Moscow, Russia.

Diseases (Basel, Switzerland)
|March 28, 2023
PubMed

Insights

Lipoprotein(a) (Lp(a)) and low IgM autoantibodies to oxidized Lp(a) (oxLp(a)) significantly increase calcific aortic valve stenosis (CAVS) risk. This finding is crucial for understanding CAVS development, especially in patients with coronary heart disease (CHD).

Area of Science:

  • Cardiology
  • Immunology
  • Biochemistry

Background:

  • Aortic valve stenosis (AVS) is a prevalent valvular heart disease.
  • Lipoprotein(a) (Lp(a)) is a known risk factor for coronary heart disease (CHD) and calcific aortic valve stenosis (CAVS).
  • The role of Lp(a) autoantibodies in CAVS pathogenesis remains under investigation.

Purpose of the Study:

  • To investigate the association between Lp(a), its autoantibodies (autoAbs), and CAVS.
  • To explore these associations in patients with and without concomitant CHD.
  • To identify independent predictors of CAVS.

Main Methods:

  • A study cohort of 250 patients was divided into three groups: CAVS with CHD, CAVS without CHD, and controls.
  • Logistic regression analysis was employed to identify predictors of CAVS.
  • Levels of Lp(a) and IgM autoantibodies to oxidized Lp(a) (oxLp(a)) were measured.

Main Results:

  • Lp(a) levels, IgM autoAbs to oxLp(a), and age were identified as independent predictors of CAVS.
  • Elevated Lp(a) (≥30 mg/dL) combined with decreased IgM autoAbs (<9.9 lab. Units) showed a significant association with CAVS (OR 6.4) and CAVS with CHD (OR 17.3).
  • IgM autoantibodies to oxLp(a) were associated with CAVS independently of Lp(a) levels and other risk factors.

Conclusions:

  • Higher Lp(a) and lower IgM autoantibodies to oxLp(a) levels are strongly associated with an increased risk of CAVS.
  • IgM autoantibodies to oxLp(a) play a significant role in CAVS development, irrespective of Lp(a) concentration.
  • These findings highlight potential therapeutic targets for managing CAVS.

Keywords:
autoantibodiescalcific aortic valve stenosiscoronary heart diseaselipoprotein(a)

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