Journal Article

The predictive value of serum lipoprotein(a) level for new-onset aortic valve calcification in patients with coronary artery disease

Deng, Yuying, Ren, Yao

2025

Overview

Background Patients suffering coronary artery disease (CAD) with calcific aortic valve disease (CAVD) are facing worse prognosis with more complex operation strategies. As the primary stage of CAVD, it is helpful to confirm the risk factors of aortic valve calcification (AVC) in advance for exploring the secondary prevention as well as early intervention strategies of CAVD for CAD patients. Lipoprotein(a) [Lp(a)] has been confirmed as the risk factor of both CAD and CAVD. But whether Lp(a) level still affects the occurrence and development of CAVD in CAD patients has not been demonstrated yet. Objective We firstly investigate the predictive value of Lp(a) for new-onset AVC in patients with CAD. Methods Patients who were admitted to the Department of Cardiology, Zhujiang Hospital, Southern Medical University from March 2021 to December 2022 and diagnosed with CAD by elective coronary angiography(CAG)were included when met the criteria. Baseline data were collected through the electronic medical record system. Patients were followed up to repeat echocardiography with an interval at least 6 months, which was up to September 2023. The primary endpoint was new-onset AVC, according to which patients were divided into new-onset AVC group ( n  = 43) and the opposite( n  = 165). Analyses were conducted using SPSS 26.0 and GraphPad Prism 10.1.2. Results A total of 208 patients with CAD were included, with a median follow-up time of 16 (12, 20) months. Compared with AVC-free group, patients with new-onset AVC had higher body mass index (BMI) ( p  = 0.003), higher proportion of tree-vessel disease( p  < 0.001), higher rates of diabetes ( p  = 0.001) and atrial fibrillation ( p  = 0.017), higher Lp(a) levels( p  < 0.001), lower left ventricular systolic function (LVEF) ( p  < 0.001) and thicker left ventricular posterior wall (LVPW) ( p  < 0.001). Increased BMI, three-vessel disease, Lp(a) > 26.65 nmol/L, increased LVPW were found independent risk factors for new-onset AVC. Using a cutoff level of 26.65 nmol/L, Lp(a) predicted new-onset AVC with a sensitivity of 79.1% and a specificity of 59.4% (AUC: 0.740, 95% CI: 0.657–0.823, p  < 0.001). When combined with BMI, there present a higher AUC value of 0.752(95%CI: 0.668–0.836, p  < 0.001); however, the statistical significance remains limited ( p  = 0.732). Conclusion High-level serum Lp(a) was independently associated with new-onset AVC in patients with CAD. Lp(a) demonstrates a significant predictive value for the onset of new AVC in CAD patients, with an established cut-off threshold of 26.65 nmol/L.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: [lp(a)]ipoprotein(a) [Lp(a)] / Aged / Angiography / Angiology / Aortic valve / Aortic Valve - diagnostic imaging / Aortic Valve - pathology / Aortic valve calcification (AVC) / Aortic Valve Disease - blood / Aortic Valve Disease - diagnostic imaging / Aortic Valve Disease - epidemiology / Aortic Valve Stenosis - blood / Aortic Valve Stenosis - diagnostic imaging / Aortic Valve Stenosis - epidemiology / Apolipoproteins / Biomarkers - blood / Blood Transfusion Medicine / Body mass index / Calcific aortic valve disease (CAVD) / Calcification / Calcification (ectopic) / Calcinosis - blood / Calcinosis - diagnostic imaging / Calcinosis - epidemiology / Cardiac arrhythmia / Cardiac Surgery / Cardiology / Cardiovascular disease / Cardiovascular research / China - epidemiology / Cholesterol / Complications and side effects / Coronary artery disease / Coronary artery disease (CAD) / Coronary Artery Disease - blood / Coronary Artery Disease - complications / Coronary Artery Disease - diagnosis / Coronary Artery Disease - diagnostic imaging / Coronary Artery Disease - epidemiology / Coronary heart disease / Coronary vessels / Diabetes / Diabetes mellitus / Echocardiography / Electronic medical records / Female / Health aspects / Heart / Heart diseases / Hemoglobin / Humans / Internal Medicine / Lipoprotein A / Lipoprotein(a) - blood / Lipoproteins / Male / Medical prognosis / Medicine / Medicine & Public Health / Middle Aged / Normal distribution / Patients / Physiological aspects / Predictive Value of Tests / Prognosis / Regression analysis / Retrospective Studies / Risk Assessment / Risk Factors / Time Factors / Trinucleotide repeats / Vein & artery diseases / Ventricle