Lipoprotein(a) and Calcific Aortic Valve Stenosis Progression

被引：0

作者：

Arsenault, Benoit J. ^{[1
,3
]}

Loganath, Krithika ^{[2
]}

Girard, Arnaud ^{[1
]}

Botezatu, Simona ^{[2
,4
]}

Zheng, Kang H. ^{[5
,6
]}

Tzolos, Evangelos ^{[2
]}

Abdoun, Kathia ^{[1
]}

Tastet, Lionel ^{[1
]}

Capoulade, Romain ^{[7
]}

Cote, Nancy ^{[1
]}

Craig, Neil ^{[2
]}

Chan, Kwan L. ^{[8
]}

Tam, James W. ^{[9
]}

Teo, Koon K. ^{[10
]}

Couture, Christian ^{[1
]}

Clavel, Marie-Annick ^{[1
,3
]}

Mathieu, Patrick ^{[1
,11
]}

Theriault, Sebastien ^{[1
,12
]}

Stroes, Erik S. G. ^{[5
]}

Newby, David E. ^{[2
]}

Tsimikas, Sotirios ^{[13
]}

Pibarot, Philippe ^{[1
,3
]}

Dweck, Marc R. ^{[2
]}

机构：

[1] Univ Laval, Ctr Rech Inst Univ Cardiol & Pneumol Quebec, 2725 Chemin Ste Foy, Quebec City, PQ G1V 4G5, Canada

[2] Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh EH16 4TJ, Scotland

[3] Univ Laval, Fac Med, Dept Med, Quebec City, PQ, Canada

[4] Univ Med & Pharm Carol Davila, Cardiol Dept, Euroecolab, Bucharest, Romania

[5] Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Vasc Med, Amsterdam, Netherlands

[6] Onze Lieve Vrouwe Gasthuis Hosp, Dept Cardiol, Amsterdam, Netherlands

[7] Nantes Univ, Ctr Hosp Univ Nantes, CNRS, Inst Thorax,Inst Natl St & Rech Med, Nantes, France

[8] Univ Ottawa Heart Inst, Dept Med, Ottawa, ON, Canada

[9] St Boniface Gen Hosp, Dept Med, Winnipeg, MB, Canada

[10] McMaster Univ, Dept Med Cardiol, Hamilton, ON, Canada

[11] Univ Laval, Fac Med, Dept Surg, Quebec City, PQ, Canada

[12] Univ Laval, Fac Med, Dept Mol Biol Med Biochem & Pathol, Quebec City, PQ, Canada

[13] Univ Calif San Diego, Dept Med, Div Cardiovasc Dis, La Jolla, CA USA

来源：

JAMA CARDIOLOGY | 2024年 / 9卷 / 09期

基金：

加拿大健康研究院;

关键词：

POSITRON-EMISSION-TOMOGRAPHY; OXIDIZED PHOSPHOLIPIDS; VALVULAR CALCIFICATION;

D O I：

10.1001/jamacardio.2024.1882

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Importance There are currently no pharmacological treatments available to slow hemodynamic progression of aortic stenosis. Plasma lipoprotein(a) concentrations predict incident aortic stenosis but its association with hemodynamic progression is controversial. Objective To determine the association between plasma lipoprotein(a) concentrations and hemodynamic progression in patients with aortic stenosis. Design, Settings and Participants The study included patients with aortic stenosis from 5 longitudinal clinical studies conducted from March 2001 to March 2023 in Canada and the UK. Of 757 total patients, data on plasma lipoprotein(a) concentrations and rates of hemodynamic progression assessed by echocardiography were available for 710, who were included in this analysis. Data were analyzed from March 2023 to April 2024. Exposure Cohort-specific plasma lipoprotein(a) concentration tertiles. Main Outcomes and Measures Hemodynamic aortic stenosis progression on echocardiography as assessed by annualized change in peak aortic jet velocity, mean transvalvular gradient, and aortic valve area. Results Among the included patients, 497 (70%) were male and 213 (30%) were female. The mean (SD) age was 65.2 (13.1) years. Patients in the top lipoprotein(a) tertile demonstrated 41% (estimate, 1.41; 95% CI, 1.13-1.75) faster progression of peak aortic jet velocity and 57% (estimate, 1.57; 95% CI, 1.18-2.10) faster progression of mean transvalvular gradient than patients in the bottom tertile. There was no evidence of heterogeneity across the individual cohorts. Progression of aortic valve area was comparable between groups (estimate, 1.23; 95% CI, 0.71-2.12). Similar results were observed when plasma lipoprotein(a) concentrations were treated as a continuous variable. Conclusions and Relevance In this study, higher plasma lipoprotein(a) concentrations were associated with faster rates of hemodynamic progression in patients with aortic stenosis. Lowering plasma lipoprotein(a) concentrations warrants further investigation in the prevention and treatment of aortic stenosis.

引用

页码：835 / 842

页数：8

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