Valvular & structural heart disease
Lipoprotein(a) and long-term structural valve degeneration of aortic bioprostheses
Authors' conclusion
Elevated Lp(a) is independently associated with long-term risk of stenotic/mixed SVD. These findings highlight Lp(a) as a promising biomarker of prosthetic valve vulnerability and support investigation of emerging Lp(a)-lowering therapies to improve valve durability.
Study context
- Population
- Bioprosthetic aortic valve replacement (AVR) patients with available Lp(a) levelsmedian echocardiographic follow-up of 7.3 years (1372 studies)
- Participants
- 174 patients
- Comparison
- Elevated Lp vs Lp ≤ 125 nmol/L
- Outcome
- SVD (VARC-3 criteria)
- Follow-up
- During
Performance
As reported in the abstract
- Patients developing structural valve degeneration (SVD)
- 40
- Stenotic
- 22
- Mixed
- 9
- Regurgitant
- 9
- 15-year cumulative incidence
- 51%
- Median onset
- 14.8 years
Further findings
| Outcome | Elevated Lp(a) | Lp(a) ≤ 125 nmol/L | Estimate | P value | |
|---|---|---|---|---|---|
| Overall SVD | 62% | 47% | SHR 2.06 (95% CI 1.09–3.91) | P = 0.026 | |
| Stenotic/mixed SVD | SHR 2.57 (95% CI 1.26–5.23) | P = 0.009 | |||
| Stenotic/mixed SVDAfter multivariable adjustment | adjusted SHR 3.00 (95% CI 1.48–6.07) | P = 0.002 | |||
| Regurgitant SVDNo association | SHR 0.85 (95% CI 0.19–3.92) | P = 0.84 | |||
| 0.10.31310Ratio (log scale) |
SVD risk per Lp(a) increase (spline modelling)
- Linear dose-response; each 25 nmol/L increase in Lp(a) conferring higher risk
- 13%
Original publication
Lipoprotein(a) and long-term structural valve degeneration of aortic bioprostheses. Eur Heart J Cardiovasc Imaging. Published 17 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it