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Lipoprotein(a) and ...
Lipoprotein(a) and the Apolipoprotein B/A1 Ratio Independently Associate With Surgery for Aortic Stenosis Only in Patients With Concomitant Coronary Artery Disease
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- Ljungberg, Johan (author)
- Umeå universitet,Kardiologi
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- Holmgren, Anders (author)
- Umeå universitet,Medicin
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- Bergdahl, Ingvar A. (author)
- Umeå universitet,Enheten för biobanksforskning,Arcum
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- Hultdin, Johan (author)
- Umeå universitet,Klinisk kemi
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- Norberg, Margareta (author)
- Umeå universitet,Epidemiologi och global hälsa,Arcum
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- Näslund, Ulf (author)
- Umeå universitet,Kardiologi,Arcum
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- Johansson, Bengt (author)
- Umeå universitet,Kardiologi
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- Söderberg, Stefan (author)
- Umeå universitet,Kardiologi
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(creator_code:org_t)
- John Wiley & Sons, 2017
- 2017
- English.
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In: Journal of the American Heart Association. - : John Wiley & Sons. - 2047-9980. ; 6:12
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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Abstract
Subject headings
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- BACKGROUND: Aortic stenosis (AS) has different clinical phenotypes, including AS with or without concomitant coronary artery disease (CAD). It is unknown whether these phenotypes share the same risk factors. In particular, lipoprotein(a) [Lp(a)] and apolipoproteins (Apo) are associated with AS, but it is unknown whether these associations differ among phenotypes. In this prospective analysis we examined the impact of Lp(a) and Apo in subgroups of patients with AS.METHODS AND RESULTS: We identified 336 patients (mean age at survey 56.7 years, 48% female) who underwent surgery for AS after a median 10.9 years (interquartile range 9.3 years), participants in 1 of 3 large population surveys. For each patient, 2 matched referents were allocated. Lp(a) and Apo were analyzed in the baseline samples. Uni- and multivariable logistic regression analyses were used to estimate risks related to a 1 (ln) standard deviation increase in Lp(a) and the ratio of Apo B to Apo A1 (Apo B/A1 ratio). High levels of Lp(a) predicted surgery for AS in 203 patients with concomitant CAD (odds ratio [95% confidence intervals]) (1.29 [1.07-1.55]), but not in 132 patients without CAD (1.04 [0.83-1.29]) in the fully adjusted model. Similarly, a high Apo B/A1 ratio predicted surgery in patients with concomitant CAD (1.43 [1.16-1.76]) but not in those without CAD (0.87 [0.69-1.10]).CONCLUSIONS: High levels of Lp(a) and a high Apo B/A1 ratio were associated with surgery for AS in patients with concomitant CAD but not in those with isolated AS. This finding may lead to a new avenue of research for targeted risk factor interventions in this population.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- aortic stenosis
- aortic valve surgery
- apolipoproteins
- lipoprotein(a)
- prospective cohort study
- risk markers
Publication and Content Type
- ref (subject category)
- art (subject category)
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