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Updated: Jul 27, 2026

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
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Published on: May 31, 2016

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Lipoprotein(a) and Calcific Aortic Valve Stenosis Progression: A Systematic Review and Meta-Analysis

Benoit J Arsenault1,2, Krithika Loganath3, Arnaud Girard1

  • 1Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada.

JAMA Cardiology
|July 17, 2024
PubMed

Insights

Higher plasma lipoprotein(a) levels accelerate aortic stenosis progression. This finding suggests that targeting lipoprotein(a) may offer a new treatment strategy for aortic stenosis patients.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Research
  • Biomarkers

Background:

  • Aortic stenosis (AS) lacks pharmacological treatments to slow hemodynamic progression.
  • Plasma lipoprotein(a) [Lp(a)] predicts AS incidence, but its role in AS progression is debated.

Purpose of the Study:

  • To investigate the association between plasma Lp(a) concentrations and the rate of hemodynamic progression in patients with AS.

Main Methods:

  • Analysis of data from 710 patients with AS across 5 longitudinal studies in Canada and the UK (2001-2023).
  • Assessment of hemodynamic progression via echocardiography, measuring annualized changes in peak aortic jet velocity, mean transvalvular gradient, and aortic valve area.
  • Stratification of patients into Lp(a) concentration tertiles for comparative analysis.

Main Results:

  • Patients in the highest Lp(a) tertile showed significantly faster progression in peak aortic jet velocity (41% faster) and mean transvalvular gradient (57% faster) compared to the lowest tertile.
  • No significant difference in aortic valve area progression was observed between Lp(a) groups.
  • Results remained consistent when Lp(a) was analyzed as a continuous variable.

Conclusions:

  • Elevated plasma Lp(a) concentrations are associated with accelerated hemodynamic progression of aortic stenosis.
  • Targeting Lp(a) may represent a potential therapeutic avenue for preventing or slowing AS progression, warranting further investigation.
Abstract

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