Rafael Zubiran: High Lp(a) Drives 1 in 15 Cases of Aortic Stenosis
Rafael Zubiran, Postdoctoral Researcher at National Heart, Lung, and Blood Institute, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in ATVB, adding:
“Lp(a) is higher 50 mg/dL accounts for roughly 1 in 15 cases of aortic stenosis!!
Our new Research Letter is out in Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB) higher lipoprotein(a) in midlife predicts clinical aortic stenosis over the following 30 years.
Despite the Lp(a)HORIZON being negative for ASCVD reductions in secondary prevention. Lp(a) continues to be a strong risk factor for ASCVD and Aortic Stenosis.
Most of the evidence linking Lp(a) to aortic valve disease comes from genetic studies and imaging of subclinical calcification, largely in White European populations.
We wanted to know whether the signal holds for hard clinical end points in a diverse US cohort, and whether it survives the competing risk of death over three decades.
Using ARIC (14,423 Black and White adults, 1,113 incident aortic stenosis cases, 7,310 deaths), we found:
- Lp(a) ≥50 mg/dL was associated with a 30% higher risk of aortic stenosis (sHR 1.30), rising to 52% when restricted to stenosis-specific codes (Aortic Stenosis and Ao Valvular Replacement)
- A dose-response, despite higher competing mortality in the high-Lp(a) group
- Lp(a) >50 mg/dL accounted for roughly 1 in 15 cases of aortic stenosis
However, despite high Lp(a) being twice as prevalent in Black participants (38% vs 16%), yet we saw no excess aortic stenosis in that group. (Some Healthcare access limitation could have mitigted the association)
A single test can help identify those with high valve risk decades before disease.
Grateful for the work of the ARIC participants and investigators.”
Title: Lipoprotein(a) and Incident Aortic Stenosis Over 30 Years: The ARIC Study
Authors: Rafael Zubirán, Anna Wolska, Alan T. Remaley
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