Identifying People at High Risk for Severe Aortic Stenosis: Aortic Valve Calcium Versus Lipoprotein(a) and Low-Density Lipoprotein Cholesterol
Authors' conclusion
AVC better identifies people at high risk for severe AS compared with Lp(a) or LDL-C, and people with AVC=0 have a very low long-term rate of severe AS regardless of Lp(a) or LDL-C level.
Study context
- Population
- MESA participants with CT-quantified aortic valve calcification (AVC), Lp(a) and low-density lipoprotein cholesterol (LDL-C) at visit 1 (2000–2002); mean age 62 years, 47% women
- Participants
- 6,792 participants
- Exposure
- AVC >0 vs AVC=0, by Lp and LDL-C levels
- Outcome
- Incident adjudicated severe AS
- Follow-up
- median 16.7-year follow-up
Main finding
As reported in the abstract
Incident severe AS
AVC=0
- Rate with Lp(a) ≥50 mg/dL
- <0.1/1000 person-years
- Rate with LDL-C ≥130 mg/dL
- 0.1/1000 person-years
AVC=0
Rate with Lp(a) ≥50 mg/dL<0.1/1000 person-years
Rate with LDL-C ≥130 mg/dL0.1/1000 person-years
AVC >0 vs AVC=0Hazard ratio (95% CI)
Lp(a) <50 mg/dL
33.8(16.4–70.0)
Lp(a) ≥50 mg/dL
61.5(7.7–494.2)
LDL-C <130 mg/dL
31.1(14.4–67.1)
LDL-C ≥130 mg/dL
50.2(13.2–191.9)
Observational data: associations, not effects.
Original publication
Identifying People at High Risk for Severe Aortic Stenosis: Aortic Valve Calcium Versus Lipoprotein(a) and Low-Density Lipoprotein Cholesterol. Circ Cardiovasc Imaging. Published 18 June 2024. doi:10.
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