Aortic stenosis
Extreme Lp(a) and extreme body weight together carry a 3.5-fold risk of calcific aortic valve disease, in 69,988 Danes (J Am Coll Cardiol 2022)
Original title: Lipoprotein(a) and Body Mass Compound the Risk of Calcific Aortic Valve Disease
In 69,988 randomly selected individuals from the Copenhagen General Population Study (2003-2015, median follow-up 7.4 years), the risk of calcific aortic valve disease rose sharply when both Lp(a) and body mass index were high. Compared with those in the 1st-49th percentile for both, multivariable-adjusted hazard ratios were 1.6 (95% CI 1.3-1.9) for the 50th-89th percentile of both (16% of individuals) and 3.5 (95% CI 2.5-5.1) for the 90th-100th percentile of both (1.1% of individuals), with no significant interaction (P=0.92). Ten-year absolute risk rose with higher Lp(a), BMI and age, and was consistently higher in men than women; for those aged 70-79 with BMI >=30.0 kg/m2, 10-year risk ranged from 5% (women) and 8% (men) at Lp(a) <=42 mg/dL to 9% and 14% respectively at Lp(a) >=80 mg/dL. The findings show extremely high Lp(a) and extremely high body mass compound to produce substantially higher aortic valve disease risk than either alone.
Original abstract
Background: High plasma lipoprotein(a) and high body mass index are both causal risk factors for calcific aortic valve disease.
Objectives: This study sought to test the hypothesis that risk of calcific aortic valve disease is the highest when both plasma lipoprotein(a) and body mass index are extremely high.
Methods: From the Copenhagen General Population Study, we used information on 69,988 randomly selected individuals recruited from 2003 to 2015 (median follow-up 7.4 years) to evaluate the association between high lipoprotein(a) and high body mass index with risk of calcific aortic valve disease.
Results: Compared with individuals in the 1st to 49th percentiles for both lipoprotein(a) and body mass index, the multivariable adjusted HRs for calcific aortic valve disease were 1.6 (95% CI: 1.3-1.9) for the 50th to 89th percentiles of both (16% of all individuals) and 3.5 (95% CI: 2.5-5.1) for the 90th to 100th percentiles of both (1.1%) (P for interaction = 0.92). The 10-year absolute risk of calcific aortic valve disease increased with higher lipoprotein(a), body mass index, and age, and was higher in men than in women. For women and men 70-79 years of age with body mass index ≥30.0 kg/m2, 10-year absolute risks were 5% and 8% for lipoprotein(a) ≤42 mg/dL (88 nmol/L), 7% and 11% for 42-79 mg/dL (89-169 nmol/L), and 9% and 14% for lipoprotein(a) ≥80 mg/dL (170 nmol/L), respectively.
Conclusions: Extremely high lipoprotein(a) levels and extremely high body mass index together conferred a 3.5-fold risk of calcific aortic valve disease. Ten-year absolute risk of calcific aortic valve disease by categories of lipoprotein(a) levels, body mass index, age, and sex ranged from 0.4% to 14%.
aortic stenosisrisk prediction
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.