Background and Aims

Aortic stenosis is most common valvular heart disease in the Western world. Lipoprotein(a) [Lp(a)] is an independent risk factor of atherosclerotic cardiovascular diseases (ASCVD) and calcific aortic valve stenosis (CAVS).

To assess the role of Lp(a) as well as autoantibodies to Lp(a) in CAVS in patients with and without ASCVD.

Methods

The study included 250 patients (mean age 69±3, males 42%) that were divided into 3 groups. There were 2 groups of patients with CAVS depending on presence (group 1) or absence of ASCVD (group 2). Control group included the patients without ASCVD or CAVS. Lipids, Lp(a), autoantibodies to Lp(a) and Cu²⁺oxidized Lp(a) [autoAbs to oxLp(a)] were measured in serum for all the patients.

Results

Indicators of aortic stenosis severity in group 2 were significant higher than in group 1: median [25;75%] of maximum jet velocity 4.65 [3.77;5.28] vs 3.85 [2.6;4.5] m/s (p<0.05), mean gradient of pressure 52.9 [40.25;69.50] vs 41.0 [24.0;55.0] mmHg (p<0.05). Lp(a) level in group 1 was 22.6 [6.5;51.1] vs group 2 (14.0 [5.9;48.3]) and group 3 (12.1[4.9;25.1]) mg/dl, (p<0.05 for both). Level of IgM autoAbs to oxLp(a) in group 1 was (8.6 [7.3;10.5]) vs group 2 (9.4 [7.7;11.2]) and group 3 (11.6 [9.4;14.6] lab.units), p<0.001. According to multifactors logistic regression analysis concentration of Lp(a), level of IgM autoAbs to oxLp(a) (p<0.05 for both) and age (p<0.001) were independent predictors of CAVS.

Conclusions

Concentration of Lp(a) associated with CAVS in patients with ASCVD. The level of IgM autoAbs to oxLp(a) are associated with CAVS regardless ASCVD.