Lipoprotein(a) is a risk factor for aortic and mitral valvular stenosis in peripheral arterial disease

Hojo, Yoshiaki; Kumakura, Hisao; Kanai, Hiroyuki; Iwasaki, Tadaaki; Ichikawa, Shûichi; Kurabayashi, Masahiko

doi:10.1093/ehjci/jev338

Cited by 26 publications

(24 citation statements)

References 37 publications

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“…Even more studies have now confirmed that high Lp(a) concentrations observationally and genetically represent strong causal risk factors for aortic valve calcification, stenosis, and stenosis progression (218)(219)(220)(221)(222)(223). This is true for Whites and Asians alike.…”

Section: Atherosclerotic Stenosismentioning

confidence: 94%

Lipoprotein (a) as a cause of cardiovascular disease: insights from epidemiology, genetics, and biology

Nordestgaard

Langsted

2016

Journal of Lipid Research

421

262

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Section: Atherosclerotic Stenosismentioning

confidence: 94%

Lipoprotein (a) as a cause of cardiovascular disease: insights from epidemiology, genetics, and biology

Nordestgaard

Langsted

2016

Journal of Lipid Research

421

262

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“…severe systemic atherosclerosis. Several studies suggested that CKD is a prognostic indicator of CVD 21,22) , and cardiovascular mortality is 10-30 times higher in patients treated with hemodialysis than in the general population 21) . Malnutrition is also an independent risk factor for mortality, with several reports showing a correlation between malnutrition and mortality in patients with CVD 5,6,23) .…”

Section: All-cause Mortalitymentioning

confidence: 99%

The Geriatric Nutritional Risk Index Predicts Long-Term Survival and Cardiovascular or Limb Events in Peripheral Arterial Disease

Matsuo

Kumakura

Kanai

et al. 2020

JAT

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The Geriatric Nutritional Risk Index (GNRI) was developed to assess the nutritional risk and is associated with mortality. However, there are limited reports on the relationship between the GNRI and overall survival (OS) in peripheral artery disease (PAD). Therefore, the purpose of this study was to examine the relationship between GNRI and OS and cardiovascular or limb events in patients with PAD. Methods: A prospective cohort study was performed on 1,219 patients with PAD. The baseline GNRI was calculated from the serum albumin level and body mass index obtained at the first visit. The patients were divided into four groups according to the GNRI: G0 (98), G1 (92-98), G2 (82-91), and G3 (82). The endpoints were OS and freedom from major adverse cardiovascular events (MACE) and MACE plus limb events (MACLE). Results: The median follow-up period was 73 months. There were 626 deaths (51.4%) during the follow-up. The rate of cardiovascular death was 51.3%. OS clearly depended on the GNRI (p 0.01), with five-year OS rates of 80.8% for G0, 62.0% for G1, 40.0% for G2, and 23.3% for G3. In multivariate analyses, the GNRI, age, ankle-brachial pressure index (ABPI), critical limb ischemia, estimated glomerular filtration rate (eGFR), and C-reactive protein (CRP) were independent factors associated with OS, and GNRI, age, ABPI, coronary artery disease, diabetes mellitus, eGFR, and CRP were associated with MACE and MACLE (all p 0.05). Statins were found to improve OS, MACE, and MACLE (p 0.01). Conclusions: GNRI is an independent predictor for OS, MACE, and MACLE in patients with PAD. Malnutrition is common and is associated with increased mortality in cardiovascular disease (CVD), such as CAD and stroke 5, 6) , and nutritional indicators such as BMI, serum albumin, and total cholesterol are predictors of survival in patients with CVD 5-7). The geriatric nutritional risk index (GNRI) is calculated from serum albumin and components of BMI and was developed as a screening tool to assess nutritional risk 8). This index is a simple and established nutritional assessment in subjects who have CVD and those on hemodialysis, as well as other elderly patients 8-11). However, long-term life expectancy, including cardiovascular events and the fate of the leg, according to the GNRI in diverse patients with PAD,

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“…There are also hints that elevated LPA levels contribute to an increased incidence of AVS [8]. In addition, very recent studies report on a relationship between mitral valve stenosis and elevated LPA levels in patients with coexisting peripheral arterial disease [17]. …”

Section: Introductionmentioning

confidence: 99%

Incidence of elevated lipoprotein (a) levels in a large cohort of patients with cardiovascular disease

Buuren

Horstkotte

Knabbe

et al. 2017

Clin Res Cardiol Suppl

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BackgroundRecently it has been demonstrated that elevated lipoprotein (a) (LPA) levels are associated with an increased risk of cardiovascular disease across multiple ethnic groups. However, there is only scanty data about the incidence of elevated LPA levels in different patient cohorts. As a consequence, we aimed to examine whether patients with elevated LPA levels might be seen more often in a cardiovascular center in comparison to the general population.MethodsWe reviewed LPA concentrations of 52,898 consecutive patients who were admitted to our hospital between January 2004 and December 2014. We subdivided them into different groups according to their LPA levels. Data was compared to available information in medical literature.Results26.4% of the patients had LPA levels >30 mg/dl which is in line with the data from literature. Mean level of LPA concentration in our study was twice as high in comparison to the general population (25.8% vs. 13.3%). 4.6% had LPA levels >98 mg/dl (general population <0.3%).ConclusionIn patients admitted to a cardiovascular center the proportion of LPA >30 mg/dl is comparable to the general population but mean levels over all are twice as high and the proportion of patients with LPA levels of >98 mg/dl is extremely higher.

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Lipoprotein(a) is a risk factor for aortic and mitral valvular stenosis in peripheral arterial disease

Abstract: The high prevalence of VHD is found, especially in AR and MR, and the Lp(a) level is associated with increased risks of AS and MS in patients with PAD.

Cited by 26 publications

References 37 publications

Lipoprotein (a) as a cause of cardiovascular disease: insights from epidemiology, genetics, and biology

Lipoprotein (a) as a cause of cardiovascular disease: insights from epidemiology, genetics, and biology

The Geriatric Nutritional Risk Index Predicts Long-Term Survival and Cardiovascular or Limb Events in Peripheral Arterial Disease

Incidence of elevated lipoprotein (a) levels in a large cohort of patients with cardiovascular disease

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