A practical review positions Lp(a) as predictive of aortic stenosis onset, progression, and even bioprosthetic valve durability (Nutr Metab Cardiovasc Dis 2025)

Original title: Lipoprotein(a) and aortic stenosis: Practical insights

Nutr Metab Cardiovasc Dis · 7 May 2025 · 5

Dimitriadis K, Kyriakoulis KG, Pyrpyris N, Beneki E, Kamperidis V, Kollias A, Cenko E, Aznaouridis K, Aggeli K, Tsioufis K

This review synthesises current literature on Lp(a) and aortic stenosis (AS), aiming to give basic and clinical scientists an up-to-date, practical overview. It documents that Lp(a) is significantly involved in AS pathogenesis, with observational studies showing patients with AS have generally higher Lp(a) levels and genetic studies proposing a causal association between elevated Lp(a) and AS development. The authors conclude that increased Lp(a) can predict the presence, development and progression of AS, and may also offer novel insight into bioprosthetic valve function and durability after valve replacement. They frame Lp(a)-specific lowering therapies, still awaited, as the key opportunity for translating these observations into prevention and treatment strategies for AS, and call for further research targeting this patient phenotype.

Original abstract

Aims: The role of Lp(a) in cardiovascular diseases is increasingly recognized, with high Lp(a) levels shown to be associated with worse outcomes. In this review, we aim to summarize the literature and the current research status regarding AS and Lp(a) with a comprehensive approach, in order to inform basic and clinical scientists with the most up-to-date data and insights.

Data Synthesis: Lp(a) is significantly involved in the pathogenesis of aortic stenosis (AS), with the interplay between AS and Lp(a) being documented in observational studies and a causal association being proposed based on genetic studies. Patients with AS have generally higher levels of Lp(a) and increased Lp(a) levels are associated with higher risk of AS development. The above observations offer opportunities for further research, mainly regarding potential therapeutic implications, particularly considering the Lp(a)-specific lowering therapies that are awaited to influence the prevention and treatment strategies for AS.

Conclusion: Increased Lp(a) levels can be predictive of the presence, development and progression of AS, as well as could offer novel insights in the pathophysiology of bioprosthetic valve function. Further research, focusing on Lp(a)-lowering agents, is key in order to identify any benefit in such patient phenotypes.

Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.