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Investigating Aortic Valve Calcification via Isolation and Culture of T Lymphocytes using Feeder Cells from Irradiated Buffy Coat
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Lipoprotein(a) and calcific aortic valve disease initiation and progression: a systematic review and meta-analysis

Panteleimon Pantelidis1, Evangelos Oikonomou1, Stamatios Lampsas1

  • 13rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, 152 Mesogeion St, Athens 11527, Greece.

Cardiovascular Research
|April 20, 2023
PubMed

Insights

Elevated lipoprotein(a) [Lp(a)] is linked to calcific aortic valve disease (CAVD) and its progression. High Lp(a) is associated with faster aortic valve stenosis progression and increased risk of adverse outcomes, even before clinical signs appear.

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Epidemiology

Background:

  • The association between lipoprotein(a) [Lp(a)] and atherosclerosis is established, but its role in calcific aortic valve disease (CAVD) remains unclear.
  • Investigating the link between Lp(a) and CAVD is crucial for understanding disease mechanisms and identifying therapeutic targets.

Approach:

  • This systematic review and meta-analysis synthesized data from 44 studies (163,139 subjects) to explore the relationship between Lp(a) and aortic valve calcification and stenosis (AVS).
  • Quantitative synthesis and meta-regression analyses were performed on eligible studies, including genetic data from eight studies.

Key Points:

  • Most studies indicate a positive association between Lp(a) and CAVD, particularly in younger individuals, with evidence of early micro-calcification.
  • Higher Lp(a) levels were observed in patients with AVS (22.63 nmol/L difference).
  • Genetic variants in the LPA gene (rs10455872, rs3798220) were associated with increased AVS risk.
  • High Lp(a) correlated with faster AVS progression (0.09 m/s/year) and a higher risk of adverse outcomes, including death (HR 1.39).

Conclusions:

  • Lipoprotein(a) significantly impacts the initiation, progression, and outcomes of CAVD.
  • Elevated Lp(a) may contribute to early subclinical lesions in CAVD.
  • These findings underscore the importance of Lp(a) as a risk factor and potential therapeutic target in CAVD.

Keywords:
Aortic valve stenosisCalcific aortic valve diseaseLipoprotein(a)Lp(a)Meta-analysis

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