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

Itamar Loewenstein1, Daniel Lichtenstein1, Ilana Goldiner2

  • 1Cardiology Department, Tel Aviv Sourasky Medical Center, Israel, Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

JACC. Advances
|September 19, 2024
PubMed

Insights

Elevated lipoprotein(a) (Lp[a]) levels show a mild increase in severe aortic stenosis (AS) patients undergoing TAVI, primarily in males. Higher Lp[a] does not correlate with earlier TAVI, suggesting no accelerated disease progression.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Chemistry
  • Genetics and Genomics

Background:

  • Limited data exists on lipoprotein(a) (Lp[a]) levels in severe aortic stenosis (AS).
  • Observational reports suggest a link between elevated Lp[a] and AS or its progression.
  • Large cohorts of verified severe AS patients are needed for comprehensive analysis.

Purpose of the Study:

  • To determine Lp[a] levels in severe AS patients referred for transcatheter aortic valve implantation (TAVI).
  • To compare Lp[a] levels in TAVI patients with a general population cohort.
  • To investigate potential associations between Lp[a] and disease progression markers.

Main Methods:

  • Comparison of Lp[a] levels from frozen serum samples of 503 TAVI patients (2012-2017) with 25,343 controls.
  • Stratification by gender and multivariable binary logistic regression analysis.
  • Investigation of association between Lp[a] cutoff (50 mg/dL) and age at TAVI.

Main Results:

  • Severe AS patients had mildly higher median Lp[a] levels than controls (20.5 vs 18.7 mg/dL, P=0.04).
  • Males with severe AS showed higher Lp[a] than controls (19.9 vs 16.6 mg/dL, P=0.04), while females showed no significant difference.
  • Lp[a] > 50 mg/dL was not associated with earlier age at TAVI (beta: 1.04; P=0.94).

Conclusions:

  • Median Lp[a] levels are only mildly elevated in severe AS patients undergoing TAVI compared to controls.
  • The observed increase in Lp[a] in AS patients is primarily driven by higher levels in males.
  • Elevated Lp[a] levels are not associated with accelerated aortic stenosis progression, as indicated by age at TAVI.
Abstract

Keywords:
aortic stenosislipoprotein atranscatheter aortic valve implantation

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