title: Lipoprotein(a) levels are associated with aortic valve calcification in asymptomatic patients with familial hypercholesterolaemia.
abstract: OBJECTIVE
  Lipoprotein(a) [Lp(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 Lp(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 Lp(a) concentration and the presence of AVC.
  
  
  RESULTS
  Aortic valve calcification was present in 38.2% of patients, including three with extensive AVC (>400 Agatston 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 Lp(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 Lp(a) concentration remained a significant predictor of AVC, with an odds ratio per 10-mg dL(-1) increase in Lp(a) concentration of 1.11 (95% confidence interval 1.01-1.20, P = 0.03).
  
  
  CONCLUSIONS
  In asymptomatic statin-treated FH patients, plasma Lp(a) concentration is an independent risk indicator for AVC.
authors.affiliation: Division of Pharmacology Vascular and Metabolic Diseases, Department of Internal Medicine, Rotterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Vongpromek
authors.affiliation: Division of Pharmacology Vascular and Metabolic Diseases, Department of Internal Medicine, Rotterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Bos
authors.affiliation: Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: G-J R
authors.initials: GJ
authors.lastname: Ten Kate
authors.affiliation: Division of Pharmacology Vascular and Metabolic Diseases, Department of Internal Medicine, Rotterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Yahya
authors.affiliation: Division of Pharmacology Vascular and Metabolic Diseases, Department of Internal Medicine, Rotterdam, The Netherlands.
authors.forename: A J M
authors.initials: AJ
authors.lastname: Verhoeven
authors.affiliation: Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.|Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: de Feyter
authors.affiliation: Division of Genetic Epidemiology, Department of Molecular and Clinical Pharmacology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Kronenberg
authors.affiliation: Division of Pharmacology Vascular and Metabolic Diseases, Department of Internal Medicine, Rotterdam, The Netherlands.
authors.forename: J E
authors.initials: JE
authors.lastname: Roeters van Lennep
authors.affiliation: Division of Pharmacology Vascular and Metabolic Diseases, Department of Internal Medicine, Rotterdam, The Netherlands.
authors.forename: E J G
authors.initials: EJ
authors.lastname: Sijbrands
authors.affiliation: Division of Pharmacology Vascular and Metabolic Diseases, Department of Internal Medicine, Rotterdam, The Netherlands.
authors.forename: M T
authors.initials: MT
authors.lastname: Mulder
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D002114:Calcinosis / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000150:complications*; D015994:Incidence; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D017270:Lipoprotein(a)
keywords: aortic valve calcification; asymptomatic; coronary artery calcification; familial hypercholesterolaemia; lipoprotein(a)