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Lipoprotein(a) and High-Sensitivity C-Reactive Protein Compound the Risk of Hypoattenuating Leaflet Thickening After

Wence Shi1, Dejing Feng1, Xiangming Hu1

  • 1Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease Chinese Academy of Medical Science and Peking Union Medical College Beijing China.

Journal of the American Heart Association
|October 18, 2024
PubMed

Insights

Elevated levels of lipoprotein(a) and high-sensitivity C-reactive protein are associated with an increased risk of hypoattenuating leaflet thickening after transcatheter aortic valve replacement. The combination of high levels of both markers significantly elevates this risk.

Area of Science:

  • Cardiology
  • Biomarkers
  • Medical Imaging

Background:

  • Hypoattenuating leaflet thickening (HALT) after transcatheter aortic valve replacement (TAVR) has an unclear mechanism.
  • The roles of lipoprotein(a) (Lp(a)) and high-sensitivity C-reactive protein (hs-CRP) in HALT are not well understood.

Purpose of the Study:

  • To investigate the association between elevated Lp(a) or hs-CRP levels and the risk of HALT following TAVR.
  • To test the hypothesis that higher Lp(a) or hs-CRP levels increase HALT risk.

Main Methods:

  • A cohort of 307 patients undergoing TAVR was analyzed.
  • Postoperative computed tomography scans were used to identify HALT.
  • Multivariable logistic regression was employed to assess the association between Lp(a), hs-CRP, and HALT risk.

Main Results:

  • The incidence of HALT within 12 months post-TAVR was 36.2%.
  • Higher baseline Lp(a) and hs-CRP levels were significantly associated with an increased risk of HALT.
  • Patients in the top 25th percentile for both Lp(a) and hs-CRP had a 4.74-fold increased risk of HALT.

Conclusions:

  • Elevated Lp(a) and hs-CRP levels are independent risk factors for HALT after TAVR.
  • The combination of high Lp(a) (≥40 mg/dL) and high hs-CRP (≥3.5 mg/L) significantly increases HALT risk by 4.74 times.
Abstract

Keywords:
high‐sensitivity C‐reactive proteinhypoattenuating leaflet thickeninglipoprotein(a)transcatheter aortic valve replacement

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