Elevated lipoprotein(a) in mitral and aortic valve calcification and disease: The Copenhagen General Population Study
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Elevated lipoprotein(a) in mitral and aortic valve calcification and disease : The Copenhagen General Population Study. / Kaltoft, Morten; Sigvardsen, Per E.; Afzal, Shoaib; Langsted, Anne; Fuchs, Andreas; Kühl, Jørgen Tobias; Køber, Lars; Kamstrup, Pia R.; Kofoed, Klaus F.; Nordestgaard, Børge G.
I: Atherosclerosis, Bind 349, 2022, s. 166-174.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Elevated lipoprotein(a) in mitral and aortic valve calcification and disease
T2 - The Copenhagen General Population Study
AU - Kaltoft, Morten
AU - Sigvardsen, Per E.
AU - Afzal, Shoaib
AU - Langsted, Anne
AU - Fuchs, Andreas
AU - Kühl, Jørgen Tobias
AU - Køber, Lars
AU - Kamstrup, Pia R.
AU - Kofoed, Klaus F.
AU - Nordestgaard, Børge G.
N1 - Publisher Copyright: © 2021 The Authors
PY - 2022
Y1 - 2022
N2 - Background and aims: We tested the hypotheses (i) that elevated lipoprotein(a) is causally associated with both mitral and aortic valve calcification and disease, and (ii) that aortic valve calcification mediates the effect of elevated lipoprotein(a) on aortic valve stenosis. Methods: From the Copenhagen General Population study, we included 12,006 individuals who underwent cardiac computed tomography to measure mitral and aortic valve calcification and 85,884 to examine risk of heart valve disease. Participants had information on plasma lipoprotein(a) and genetic instruments associated with plasma lipoprotein(a) to investigate potential causality. Results: At age 70–79 years, 29% and 54% had mitral and aortic valve calcification, respectively. For 10-fold higher lipoprotein(a) levels, multifactorially adjusted odds ratios for mitral and aortic valve calcification were 1.26 (95% confidence interval: 1.13–1.41) and 1.62 (1.48–1.77). For mitral and aortic valve stenosis, corresponding hazard ratios were 0.93 (95%CI:0.40–2.15, 19 events) and 1.54 (1.38–1.71, 1158 events), respectively. For ≤23 versus ≥36 kringle IV type 2 number of repeats, the age and sex adjusted odds ratios for mitral and aortic valve calcification were 1.53 (1.18–1.99) and 2.23 (1.81–2.76). For carriers versus non-carriers of LPA rs10455872, odds ratios for mitral and aortic valve calcification were 1.33 (1.13–1.57) and 1.86 (1.64–2.13). For aortic valve stenosis, 31% (95%CI:16%–76%) of the effect of lipoprotein(a) was mediated through calcification. Conclusions: Elevated lipoprotein(a) was genetically and observationally associated with mitral and aortic valve calcification and aortic valve stenosis. Aortic valve calcification mediated 31% of the effect of elevated lipoprotein(a) on aortic valve stenosis.
AB - Background and aims: We tested the hypotheses (i) that elevated lipoprotein(a) is causally associated with both mitral and aortic valve calcification and disease, and (ii) that aortic valve calcification mediates the effect of elevated lipoprotein(a) on aortic valve stenosis. Methods: From the Copenhagen General Population study, we included 12,006 individuals who underwent cardiac computed tomography to measure mitral and aortic valve calcification and 85,884 to examine risk of heart valve disease. Participants had information on plasma lipoprotein(a) and genetic instruments associated with plasma lipoprotein(a) to investigate potential causality. Results: At age 70–79 years, 29% and 54% had mitral and aortic valve calcification, respectively. For 10-fold higher lipoprotein(a) levels, multifactorially adjusted odds ratios for mitral and aortic valve calcification were 1.26 (95% confidence interval: 1.13–1.41) and 1.62 (1.48–1.77). For mitral and aortic valve stenosis, corresponding hazard ratios were 0.93 (95%CI:0.40–2.15, 19 events) and 1.54 (1.38–1.71, 1158 events), respectively. For ≤23 versus ≥36 kringle IV type 2 number of repeats, the age and sex adjusted odds ratios for mitral and aortic valve calcification were 1.53 (1.18–1.99) and 2.23 (1.81–2.76). For carriers versus non-carriers of LPA rs10455872, odds ratios for mitral and aortic valve calcification were 1.33 (1.13–1.57) and 1.86 (1.64–2.13). For aortic valve stenosis, 31% (95%CI:16%–76%) of the effect of lipoprotein(a) was mediated through calcification. Conclusions: Elevated lipoprotein(a) was genetically and observationally associated with mitral and aortic valve calcification and aortic valve stenosis. Aortic valve calcification mediated 31% of the effect of elevated lipoprotein(a) on aortic valve stenosis.
KW - Heart valve
KW - Lp(a)
KW - Stenosis
U2 - 10.1016/j.atherosclerosis.2021.11.029
DO - 10.1016/j.atherosclerosis.2021.11.029
M3 - Journal article
C2 - 34903381
AN - SCOPUS:85121273008
VL - 349
SP - 166
EP - 174
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
ER -
ID: 288185435