Aortic stenosis
Lp(a) above 50 mg/dL, but not 30 mg/dL, is significantly linked to calcific aortic valve disease, a meta-analysis of 52,931 participants across 8 studies (Front Cardiovasc Med 2022)
Original title: Association Between Lipoprotein(a) and Calcific Aortic Valve Disease: A Systematic Review and Meta-Analysis
This systematic review and meta-analysis pooled 8 studies (52,931 participants: 4 cohort, 4 case-control; 5 high quality, 3 moderate quality) examining Lp(a) and calcific aortic valve disease (CAVD). Plasma Lp(a) >=50 mg/dL was associated with a 1.76-fold increased risk of CAVD (RR 1.76, 95% CI 1.47-2.11), whereas Lp(a) >=30 mg/dL showed no significant association (RR 1.28, 95% CI 0.98-1.68). In subgroup analysis restricted to cohort studies, both the >=50 mg/dL (RR 1.70, 95% CI 1.39-2.07) and >=30 mg/dL thresholds (RR 1.38, 95% CI 1.19-1.61) were significantly associated with CAVD. The findings confirm that high plasma Lp(a) (>=50 mg/dL) is significantly associated with increased CAVD risk, with the strength of association depending on the cut-off used and study design.
Original abstract
Background: Preliminary studies indicated that enhanced plasma levels of lipoprotein(a) [lp(a)] might link with the risk of calcific aortic valve disease (CAVD), but the clinical association between them remained inconclusive. This systematic review and meta-analysis were aimed to determine this association.
Methods: We comprehensively searched PubMed, Embase, Web of Science, and Scopus databases for studies reporting the incidence of CAVD and their plasma lp(a) concentrations. Pooled risk ratio (RR) and 95% confidence interval (95% CI) were calculated to evaluate the effect of lp(a) on CAVD using the random-effects model. Subgroup analyses by study types, countries, and the level of adjustment were also conducted. Funnel plots, Egger's test and Begg's test were conducted to evaluate the publication bias.
Results: Eight eligible studies with 52,931 participants were included in this systematic review and meta-analysis. Of these, four were cohort studies and four were case-control studies. Five studies were rated as high quality, three as moderate quality. The pooled results showed that plasma lp(a) levels ≥50 mg/dL were associated with a 1.76-fold increased risk of CAVD (RR, 1.76; 95% CI, 1.47-2.11), but lp(a) levels ≥30 mg/dL were not observed to be significantly related with CAVD (RR, 1.28; 95% CI, 0.98-1.68). We performed subgroup analyses by study type, the RRs of cohort studies revealed lp(a) levels ≥50 mg/dL and lp(a) levels ≥30 mg/dL have positive association with CAVD (RR, 1.70; 95% CI, 1.39-2.07; RR 1.38; 95% CI, 1.19-1.61).
Conclusion: High plasma lp(a) levels (≥50 mg/dL) are significantly associated with increased risk of CAVD.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.