Lipoprotein(a) is robustly associated with aortic valve calcium

Yannick Kaiser; Sunny S. Singh; Kang H. Zheng; Rutger Verbeek; Maryam Kavousi; Sara Joan Pinto; Meike W. Vernooij; Eric J.G. Sijbrands; S. Matthijs Boekholdt; Yolanda B. de Rijke; Erik S.G. Stroes; Daniel Bos

doi:10.1136/heartjnl-2021-319044

Lipoprotein(a) is robustly associated with aortic valve calcium

Yannick Kaiser, Sunny S. Singh, Kang H. Zheng, Rutger Verbeek, Maryam Kavousi, Sara Joan Pinto, Meike W. Vernooij, Eric J.G. Sijbrands, S. Matthijs Boekholdt, Yolanda B. de Rijke, Erik S.G. Stroes, Daniel Bos^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

36 Citations (Scopus)

Abstract

To investigate the prevalence and quantity of aortic valve calcium (AVC) in two large cohorts, stratified according to age and lipoprotein(a) (Lp(a)), and to assess the association between Lp(a) and AVC. We included 2412 participants from the population-based Rotterdam Study (52% women, mean age=69.6±6.3 years) and 859 apparently healthy individuals from the Amsterdam University Medical Centers (UMC) outpatient clinic (57% women, mean age=45.9±11.6 years). All individuals underwent blood sampling to determine Lp(a) concentration and non-enhanced cardiac CT to assess AVC. Logistic and linear regression analyses were performed to investigate the associations of Lp(a) with the presence and amount of AVC. The prevalence of AVC was 33.1% in the Rotterdam Study and 5.4% in the Amsterdam UMC cohort. Higher Lp(a) concentrations were independently associated with presence of AVC in both cohorts (OR per 50 mg/dL increase in Lp(a): 1.54 (95% CI 1.36 to 1.75) in the Rotterdam Study cohort and 2.02 (95% CI 1.19 to 3.44) in the Amsterdam UMC cohort). In the Rotterdam Study cohort, higher Lp(a) concentrations were also associated with increase in aortic valve Agatston score (β 0.19, 95% CI 0.06 to 0.32 per 50 mg/dL increase). Lp(a) is robustly associated with presence of AVC in a wide age range of individuals. These results provide further rationale to assess the effect of Lp(a) lowering interventions in individuals with early AVC to prevent end-stage aortic valve stenosis.

Original language	English
Pages (from-to)	1422-1428
Number of pages	7
Journal	Heart
Volume	107
Issue number	17
DOIs	https://doi.org/10.1136/heartjnl-2021-319044
Publication status	Published - 1 Sept 2021

Bibliographical note

Funding Information:
The Rotterdam Study is supported by Erasmus MC and Erasmus University Rotterdam; the Netherlands Organization for Scientific Research; the Netherlands Organization for Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly; the Netherlands Genomics Initiative; the Ministry of Education, Culture and Science; the Ministry of Health, Welfare and Sport; European Commission; and the Municipality of Rotterdam. YK and ESGS were supported by the Netherlands Heart Foundation (CVON 2017-20: generating the best evidence-based pharmaceutical targets for atherosclerosis (GENIUS II)).

Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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@article{69ef50c1528148f59818af64660a63fb,

title = "Lipoprotein(a) is robustly associated with aortic valve calcium",

abstract = "To investigate the prevalence and quantity of aortic valve calcium (AVC) in two large cohorts, stratified according to age and lipoprotein(a) (Lp(a)), and to assess the association between Lp(a) and AVC. We included 2412 participants from the population-based Rotterdam Study (52% women, mean age=69.6±6.3 years) and 859 apparently healthy individuals from the Amsterdam University Medical Centers (UMC) outpatient clinic (57% women, mean age=45.9±11.6 years). All individuals underwent blood sampling to determine Lp(a) concentration and non-enhanced cardiac CT to assess AVC. Logistic and linear regression analyses were performed to investigate the associations of Lp(a) with the presence and amount of AVC. The prevalence of AVC was 33.1% in the Rotterdam Study and 5.4% in the Amsterdam UMC cohort. Higher Lp(a) concentrations were independently associated with presence of AVC in both cohorts (OR per 50 mg/dL increase in Lp(a): 1.54 (95% CI 1.36 to 1.75) in the Rotterdam Study cohort and 2.02 (95% CI 1.19 to 3.44) in the Amsterdam UMC cohort). In the Rotterdam Study cohort, higher Lp(a) concentrations were also associated with increase in aortic valve Agatston score (β 0.19, 95% CI 0.06 to 0.32 per 50 mg/dL increase). Lp(a) is robustly associated with presence of AVC in a wide age range of individuals. These results provide further rationale to assess the effect of Lp(a) lowering interventions in individuals with early AVC to prevent end-stage aortic valve stenosis.",

author = "Yannick Kaiser and Singh, {Sunny S.} and Zheng, {Kang H.} and Rutger Verbeek and Maryam Kavousi and Pinto, {Sara Joan} and Vernooij, {Meike W.} and Sijbrands, {Eric J.G.} and Boekholdt, {S. Matthijs} and {de Rijke}, {Yolanda B.} and Stroes, {Erik S.G.} and Daniel Bos",

note = "Funding Information: The Rotterdam Study is supported by Erasmus MC and Erasmus University Rotterdam; the Netherlands Organization for Scientific Research; the Netherlands Organization for Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly; the Netherlands Genomics Initiative; the Ministry of Education, Culture and Science; the Ministry of Health, Welfare and Sport; European Commission; and the Municipality of Rotterdam. YK and ESGS were supported by the Netherlands Heart Foundation (CVON 2017-20: generating the best evidence-based pharmaceutical targets for atherosclerosis (GENIUS II)). Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2021",

month = sep,

day = "1",

doi = "10.1136/heartjnl-2021-319044",

language = "English",

volume = "107",

pages = "1422--1428",

journal = "Heart",

issn = "1355-6037",

publisher = "BMJ Publishing Group",

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T1 - Lipoprotein(a) is robustly associated with aortic valve calcium

AU - Kaiser, Yannick

AU - Singh, Sunny S.

AU - Zheng, Kang H.

AU - Verbeek, Rutger

AU - Kavousi, Maryam

AU - Pinto, Sara Joan

AU - Vernooij, Meike W.

AU - Sijbrands, Eric J.G.

AU - Boekholdt, S. Matthijs

AU - de Rijke, Yolanda B.

AU - Stroes, Erik S.G.

AU - Bos, Daniel

N1 - Funding Information: The Rotterdam Study is supported by Erasmus MC and Erasmus University Rotterdam; the Netherlands Organization for Scientific Research; the Netherlands Organization for Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly; the Netherlands Genomics Initiative; the Ministry of Education, Culture and Science; the Ministry of Health, Welfare and Sport; European Commission; and the Municipality of Rotterdam. YK and ESGS were supported by the Netherlands Heart Foundation (CVON 2017-20: generating the best evidence-based pharmaceutical targets for atherosclerosis (GENIUS II)). Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2021/9/1

Y1 - 2021/9/1

N2 - To investigate the prevalence and quantity of aortic valve calcium (AVC) in two large cohorts, stratified according to age and lipoprotein(a) (Lp(a)), and to assess the association between Lp(a) and AVC. We included 2412 participants from the population-based Rotterdam Study (52% women, mean age=69.6±6.3 years) and 859 apparently healthy individuals from the Amsterdam University Medical Centers (UMC) outpatient clinic (57% women, mean age=45.9±11.6 years). All individuals underwent blood sampling to determine Lp(a) concentration and non-enhanced cardiac CT to assess AVC. Logistic and linear regression analyses were performed to investigate the associations of Lp(a) with the presence and amount of AVC. The prevalence of AVC was 33.1% in the Rotterdam Study and 5.4% in the Amsterdam UMC cohort. Higher Lp(a) concentrations were independently associated with presence of AVC in both cohorts (OR per 50 mg/dL increase in Lp(a): 1.54 (95% CI 1.36 to 1.75) in the Rotterdam Study cohort and 2.02 (95% CI 1.19 to 3.44) in the Amsterdam UMC cohort). In the Rotterdam Study cohort, higher Lp(a) concentrations were also associated with increase in aortic valve Agatston score (β 0.19, 95% CI 0.06 to 0.32 per 50 mg/dL increase). Lp(a) is robustly associated with presence of AVC in a wide age range of individuals. These results provide further rationale to assess the effect of Lp(a) lowering interventions in individuals with early AVC to prevent end-stage aortic valve stenosis.

AB - To investigate the prevalence and quantity of aortic valve calcium (AVC) in two large cohorts, stratified according to age and lipoprotein(a) (Lp(a)), and to assess the association between Lp(a) and AVC. We included 2412 participants from the population-based Rotterdam Study (52% women, mean age=69.6±6.3 years) and 859 apparently healthy individuals from the Amsterdam University Medical Centers (UMC) outpatient clinic (57% women, mean age=45.9±11.6 years). All individuals underwent blood sampling to determine Lp(a) concentration and non-enhanced cardiac CT to assess AVC. Logistic and linear regression analyses were performed to investigate the associations of Lp(a) with the presence and amount of AVC. The prevalence of AVC was 33.1% in the Rotterdam Study and 5.4% in the Amsterdam UMC cohort. Higher Lp(a) concentrations were independently associated with presence of AVC in both cohorts (OR per 50 mg/dL increase in Lp(a): 1.54 (95% CI 1.36 to 1.75) in the Rotterdam Study cohort and 2.02 (95% CI 1.19 to 3.44) in the Amsterdam UMC cohort). In the Rotterdam Study cohort, higher Lp(a) concentrations were also associated with increase in aortic valve Agatston score (β 0.19, 95% CI 0.06 to 0.32 per 50 mg/dL increase). Lp(a) is robustly associated with presence of AVC in a wide age range of individuals. These results provide further rationale to assess the effect of Lp(a) lowering interventions in individuals with early AVC to prevent end-stage aortic valve stenosis.

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DO - 10.1136/heartjnl-2021-319044

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SN - 1355-6037

VL - 107

SP - 1422

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JO - Heart

JF - Heart

IS - 17

ER -

Lipoprotein(a) is robustly associated with aortic valve calcium

Abstract

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