Association of <i>LPA</i> Variants With Aortic Stenosis

Chen, Hao Yu; Dufresne, Line; Burr, Hermann; Ambikkumar, Athithan; Yasui, Niko; Luk, Kevin; Ranatunga, Dilrini K.; Whitmer, Rachel A.; Lathrop, Mark; Engert, James C.; Thanassoulis, George

doi:10.1001/jamacardio.2017.4266

Cited by 52 publications

(30 citation statements)

References 25 publications

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“…Interestingly, there is a strong established link between Lp(a) and calcific aortic valve stenosis (CAVS) though the mechanism remains unclear. [ 43 , 44 ]…”

Section: Lipoprotein(a)mentioning

confidence: 99%

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Assessing Atherosclerotic Cardiovascular Disease Risk with Advanced Lipid Testing: State of the Science

German

Shapiro

2020

Eur Cardiol

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Cardiovascular disease is the number one cause of death and disability worldwide. While substantial gains have been made in reducing cardiovascular mortality, future projections suggest that we have reached a nadir and may be at an inflection point, given the rising tide of obesity and diabetes. Evaluation and management of plasma lipids is central to the prevention of atherosclerotic cardiovascular disease. Although the standard lipid panel represents a well-established platform to assess risk, this test alone can be insufficient and/or misleading. Advances in our understanding of atherosclerosis have led to the development of lipid-based biomarkers that help to discriminate the risk of cardiovascular disease when it is unclear. While these biomarkers provide novel information, their implementation into clinical medicine remains difficult given discrepancies in the literature, lack of assay standardisation, poor accessibility and high cost. However, additional measures of atherogenic lipoproteins or their surrogates may offer insight beyond the standard lipid panel, providing a more precise assessment of risk and more accurate assessment of lipid-lowering therapy.

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“…Interestingly, there is a strong established link between Lp(a) and calcific aortic valve stenosis (CAVS) though the mechanism remains unclear. [ 43 , 44 ]…”

Section: Lipoprotein(a)mentioning

confidence: 99%

“…Additionally, Lp(a) levels remain stable throughout life regardless of lifestyle. Interestingly, there is a strong established link between Lp(a) and calcific aortic valve stenosis (CAVS) though the mechanism remains unclear 43,44. High-quality evidence supports the relationship between Lp(a) and important CVD-related outcomes.…”

mentioning

confidence: 99%

Assessing Atherosclerotic Cardiovascular Disease Risk with Advanced Lipid Testing: State of the Science

German

Shapiro

2020

Eur Cardiol

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“…Recent study confirmed the association between 2 LPA variants (rs10455872 and rs 3798220) and aortic stenosis. In this study it has been proven that individuals with two risk alleles have 2-fold greater odds of developing aortic stenosis [ 40 ].…”

Section: Lipid Theorymentioning

confidence: 99%

Degenerative Aortic Stenosis, Dyslipidemia and Possibilities of Medical Treatment

Kleinauskienė

Jonkaitienė

2018

Medicina

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Degenerative aortic stenosis (DAS) is the most frequently diagnosed heart valve disease in Europe and North America. DAS is a chronic progressive disease which resembles development of atherosclerosis. Endothelial dysfunction, lipid infiltration, calcification and ossification are evidenced in both diseases. The same risk factors such as older age, male sex, smoking, and elevated levels of lipids are identified. The effect of smoking, visceral obesity, metabolic syndrome, hypercholesterolemia, low-density lipoprotein, high-density lipoprotein, lipoprotein(a), adiponectin and apolipoprotein(a) on development of DAS are being studied. The search for genetic ties between disorders of lipid metabolism and DAS has been started. DAS is characterized by a long symptom-free period which can last for several decades. Aortic valve replacement surgery is necessary when the symptoms occur. The lipid-lowering therapy effect on stopping or at least slowing down the progression of DAS was studied. However, the results of the conducted clinical trials are controversial. In addition, calcium homeostasis, bone metabolism and calcinosis-reducing medication are being studied. Although prospective randomized clinical trials have not demonstrated any positive effect of statins used for slowing progression of the disease, statins are still recommended for patients with dyslipidemia. Recent study has suggested that a specific modification of treatment, based on severity of disease, may have a beneficial effect in patients with aortic sclerosis and mild DAS. New clinical studies analyzing new treatment possibilities which could correct the natural course of the disease and reduce the need for aortic valve replacement by surgery or transcatheter treatment interventions are needed.

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“…Recent multi-center trials report a high prevalence (~60%) of significant coronary stenosis among patients undergoing transcatheter aortic valve implantation (TAVI) [ 1 , 2 ]. The strong association between the two conditions is primarily due to an ensemble of clinical and genetic risk factors shared by both diseases including age, smoking, hypertension and hyperlipidemia [ 3 ]. The management of CAD is a central aspect of the work-up for TAVI, but the evidence available is still limited and the best percutaneous coronary intervention (PCI) practice in TAVI candidates is yet to be determined.…”

Section: Introductionmentioning

confidence: 99%

Aortic Valve Disease and Associated Complex CAD: The Interventional Approach

Marin

Scarsini

Kotronias

et al. 2021

JCM

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Coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis (AS). The management of CAD is a central aspect of the work-up of patients undergoing transcatheter aortic valve implantation (TAVI), but few data are available on this field and the best percutaneous coronary intervention (PCI) practice is yet to be determined. A major challenge is the ability to elucidate the severity of bystander coronary stenosis independently of the severity of aortic valve stenosis and subsequent impact on blood flow. The prognostic role of CAD in patients undergoing TAVI is being still debated and the benefits and the best timing of PCI in this context are currently under evaluation. Additionally, PCI in the setting of advanced AS poses some technical challenges, due to the complex anatomy, risk of hemodynamic instability, and the increased risk of bleeding complications. This review aims to provide a comprehensive synthesis of the available literature on myocardial revascularization in patients with severe AS undergoing TAVI. This work can assist the Heart Team in individualizing decisions about myocardial revascularization, taking into account available diagnostic tools as well as the risks and benefits.

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Association of LPA Variants With Aortic Stenosis

Cited by 52 publications

References 25 publications

Assessing Atherosclerotic Cardiovascular Disease Risk with Advanced Lipid Testing: State of the Science

Assessing Atherosclerotic Cardiovascular Disease Risk with Advanced Lipid Testing: State of the Science

Degenerative Aortic Stenosis, Dyslipidemia and Possibilities of Medical Treatment

Aortic Valve Disease and Associated Complex CAD: The Interventional Approach

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