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Lipoprotein(a) levels are associated with aortic valve calcification in asymptomatic patients with familial hypercholesterolaemia
Author(s) -
Vongpromek R.,
Bos S.,
Kate G.J. R.,
Yahya R.,
Verhoeven A. J. M.,
Feyter P. J.,
Kronenberg F.,
Roeters van Lennep J. E.,
Sijbrands E. J. G.,
Mulder M. T.
Publication year - 2015
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/joim.12335
Subject(s) - medicine , asymptomatic , odds ratio , lipoprotein(a) , cardiology , gastroenterology , apolipoprotein b , population , confidence interval , body mass index , aortic valve , risk factor , aortic valve stenosis , univariate analysis , cholesterol , multivariate analysis , environmental health
Abstract Objectives L ipoprotein(a) [ L p(a)] is an independent risk factor for aortic valve stenosis and aortic valve calcification ( AVC ) in the general population. In this study, we determined the association between AVC and both plasma L p(a) levels and apolipoprotein(a) [apo(a)] kringle IV repeat polymorphisms in asymptomatic statin‐treated patients with heterozygous familial hypercholesterolaemia ( FH ). Methods A total of 129 asymptomatic heterozygous FH patients (age 40–69 years) were included in this study. AVC was detected using computed tomography scanning. Lp(a) concentration and apo(a) kringle IV repeat number were measured using immunoturbidimetry and immunoblotting, respectively. Univariate and multivariate logistic regression were used to assess the association between L p(a) concentration and the presence of AVC . Results Aortic valve calcification was present in 38.2% of patients, including three with extensive AVC (>400 A gatston units). Lp(a) concentration was significantly correlated with gender, number of apo(a) kringle IV repeats and the presence and severity of AVC , but not with coronary artery calcification ( CAC ). AVC was significantly associated with plasma L p(a) level, age, body mass index, blood pressure, duration of statin use, cholesterol‐year score and CAC score. After adjustment for all significant covariables, plasma L p(a) concentration remained a significant predictor of AVC , with an odds ratio per 10‐mg dL −1 increase in L p(a) concentration of 1.11 (95% confidence interval 1.01–1.20, P = 0.03). Conclusion In asymptomatic statin‐treated FH patients, plasma Lp(a) concentration is an independent risk indicator for AVC .