Aspirin use, lipoprotein(a), and calcific aortic valve disease: the Multi-ethnic Study of Atherosclerosis
Authors' conclusion
In this exploratory analysis of prospective observational cohort data, regular aspirin use was associated with a lower risk of AVC and severe AS in persons with high Lp(a), but not high LDL-C.
Study context
- Population
- Participants in the Multi-Ethnic Study of Atherosclerosis; mean age 62 years, 53% womenup to 6598
- Participants
- 6,598 participants
- Exposure
- Regular aspirin use vs No regular aspirin use
- Outcome
- Incident aortic valve calcium (AVC, cardiac CT) and severe AS, across Lp(a) and LDL-C levels
Methodological detailssecondary analysis of MESA, exploratory analysis, observational
- Secondary analysis of MESA
- Exploratory analysis
- Observational
Main finding
As reported in the abstract
Incident AVC and severe AS by Lp(a) and LDL-C stratum
HR
- Incident aortic valve calcium (AVC), Lp(a) ≥75 mg/dL
- .42 (95% CI .19-.93)
- Incident AVC, Lp(a) ≥100 mg/dL
- .17 (95% CI .04-.67)
- Severe aortic stenosis (AS), Lp(a) ≥50 mg/dL
- .13 (95% CI .04-.47)
- Severe AS, Lp(a) ≥75 mg/dL
- .02 (95% CI .001-.29)
- Incident AVC, LDL-C ≥130 mg/dL
- 1.02 (95% CI .66-1.58)
- Incident AVC, LDL-C ≥160 mg/dL
- 1.51 (95% CI .53-4.28)
- Severe AS, LDL-C ≥100 mg/dL
- .70 (95% CI .39-1.26)
- Severe AS, LDL-C ≥130 mg/dL
- .46 (95% CI .14-1.47)
Observational data: associations, not effects.
Further findings
Cohort incidence
- Regular aspirin use
- 23%
- Developed AVC (median 8.9 years)
- 8%
- Developed severe AS (median 16.7 years)
- 1%
Original publication
Aspirin use, lipoprotein(a), and calcific aortic valve disease: the Multi-ethnic Study of Atherosclerosis. Eur Heart J. Published 21 February 2026. doi:10.
Summarised from the published abstract; every number is checked against it