SPC365

The Potential Role of Elevated Lipoprotein(a) in the Early Stages of Aortic Valve Stenosis

Session: SESSÃO DE POSTERS 16 - DIAGNÓSTICO E PROGNÓSTICO NA ESTENOSE AÓRTICA
Speaker: Francisco Sousa

Congress: CPC 2025
Topic: F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme: 15. Valvular Heart Disease
Subtheme: 15.1 Valvular Heart Disease – Pathophysiology and Mechanisms
Session Type: Cartazes
FP Number: ---
Authors: Francisco Sousa; Maria Isabel Mendonça; João Adriano Sousa; Débora Sá; Matilde Ferreira; Gonçalo Abreu; Sónia Freitas; Eva Henriques; Mariana Rodrigues; António Drumond; Ana Célia Sousa; Roberto Palma Dos Reis

<p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Introduction:</strong> High levels of Liproprotein (a) have been linked with atherosclerosis,</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">having a great impact on the entire cardiovascular system and the aortic valve is no&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">exception. Elevated Lp(a) levels have been associated with the development of severe&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">aortic stenosis, but it is still unknown if its pro inflammatory and atherogenic properties&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">are key to initial aortic valve calcification.</span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Objective:</strong> Determine if elevated Lp(a) levels are associated with aortic valve&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">calcification.</span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Methods:</strong> Aortic valve calcium was measured in 228 individuals under 65 years with no&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">prior diagnosis of cardiovascular disease. Valvular calcium score was measured by CT&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">angiography and reported in Agatston units. The population was divided into two&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">groups: AVC = 0; AVC&gt;0. Patients with likely severe aortic stenosis were excluded&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">(Men &gt;2000 A.U; Women &gt;1200 A.U). According to current evidence an Lp(a) was&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">considered elevated &gt; 30 mg/dl. Bivariate and multivariate analyses were conducted to&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">understand the influence of LPA levels on aortic valve calcification after adjusting for&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">traditional risk factors.</span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Results:</strong> Individuals with elevated and LPA levels (&gt;30 mg/dl) were more likely to have&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">aortic valve calcification, 38.0%, when compared with the ones with lower Lpa levels&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">(&lt;30 mg/dl) 15.8% (p&lt;0.01). Traditional risk factors such as older age, obesity, male&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">sex and hypertension, were significant in the bivariate analysis. After multivariate&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">analysis, it was clear that LPa &gt;30 mg/dl remained an independent risk factor for aortic&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">valve calcification (p=0.015; OR 3.25) along with obesity (p=0.039; OR 2.62), male sex&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">(p= 0.029; OR 2.58) and older age (p&amp;lt;0.0001; OR 1.18).</span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion:</strong> Levels of Lpa higher than 30 mg/dl were associated with early aortic valve&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">calcification, supporting its role in the early stages of the development of aortic stenosis.&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Future studies might shed a light if Lpa level control through medication could prevent&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">the progression of aortic stenosis.</span></span></p>