Aortic stenosis
Comparing 503 TAVI patients against 25,343 controls finds only a mild Lp(a) elevation in severe aortic stenosis, driven by men (JACC Adv 2024)
Original title: Lipoprotein(a) Levels in Severe Aortic Stenosis Referred for Transcatheter Aortic Valve Implantation Compared to Controls
This study compared Lp(a) levels from frozen serum samples of 503 patients with severe aortic stenosis referred for transcatheter aortic valve implantation (TAVI) between 2012 and 2017 against 25,343 general-population controls with Lp(a) measured for any reason, stratified by sex. Median Lp(a) was only mildly higher in the TAVI group than controls overall (20.5 vs. 18.7 mg/dL, P = 0.04), a difference driven by men (19.9 vs. 16.6 mg/dL, P = 0.04), while women showed no significant difference (22.1 vs. 21.3 mg/dL, P = 0.87). In multivariable analysis, an Lp(a) cutoff above 50 mg/dL was not associated with younger age at TAVI (beta 1.04, 95% CI 0.42-2.57, P = 0.94). Against this large control cohort, the Lp(a)-aortic stenosis association appears modest and sex-dependent, and elevated Lp(a) did not predict accelerated disease progression to the point of TAVI referral.
Original abstract
Background: Limited observational reports link elevated lipoprotein(a) (Lp[a]) levels to aortic stenosis (AS) or to disease progression. Data on large cohorts of verified severe AS patients are lacking.
Objectives: The purpose of the study was to characterize Lp(a) levels of severe AS patients referred to transcatheter aortic valve implantation (TAVI) and compare them to a large cohort of Lp(a) samples derived from the general population.
Methods: Lp(a) levels obtained from frozen serum samples of TAVI patients between 2012 and 2017 were compared to a control group for whom Lp(a) levels were obtained for any reason and stratified by gender. Multivariable binary logistic regression analyses were conducted to investigate associations between younger age at TAVI and an Lp(a) cutoff of 50 mg/dL.
Results: Lp(a) levels of 503 TAVI were compared to 25,343 controls. Patients in the AS group had mildly higher median Lp(a) levels compared to controls (20.5 vs 18.7 mg/dL, P = 0.04). Lp(a) levels in males with severe AS were higher than controls (19.9 vs 16.6 mg/dL, P = 0.04). Females had a nonsignificant difference (22.1 vs 21.3 mg/dL, P = 0.87). In multivariable analysis, an Lp(a) cutoff of above 50 mg/dL was not associated with an earlier age at TAVI (beta: 1.04; 95% CI: 0.42-2.57; P = 0.94).
Conclusions: Median Lp(a) levels were only mildly higher in severe AS patients undergoing TAVI in comparison to a large control group, mainly driven by higher Lp(a) levels in males. Higher Lp(a) levels were not associated with an earlier age at TAVI, rejecting its association with an accelerated disease progression.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.