Prevention & lipidsCohort study

Aspirin use, lipoprotein(a), and calcific aortic valve disease: the Multi-ethnic Study of Atherosclerosis

Eur Heart JPublished

  • Prospective cohort study (secondary analysis of MESA)
  • exploratory analysis
  • observational

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

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:10.1093/eurheartj/ehag018

Summarised from the published abstract; every number is checked against it