15289-s-bos

72 | Chapter 5 Abstract Objectives Lipoprotein(a) [Lp(a)] is an independent risk factor for aortic valve stenosis and aortic valve calcification (AVC) in the general population. In this study, we determined the association between AVC and both plasma Lp(a) levels and apolipoprotein( a) [apo(a)] kringle IV repeat polymorphisms in asymptomatic statin-treated patients with heterozygous familial hypercholesterolaemia (FH). Methods A total of 129asymptomaticheterozygous FHpatients (age40–69years)were included in this study. AVCwas detectedusingcomputed tomography scanning. Lp(a) concentration and apo(a) kringle IV repeat number were measured using immunoturbidimetry and immunoblotting, respectively. Univariate and multivariate logistic regression were used to assess the association between Lp(a) concentration and the presence of AVC. Results Aortic valve calcificationwas present in 38.2%of patients, including three with extensive AVC (>400 Agatston units). Lp(a) concentration was significantly correlated with gender, number of apo(a) kringle IV repeats and the presence and severity of AVC, but not with coronary artery calcification (CAC). AVC was significantly associated with plasma Lp(a) level, age, body mass index, blood pressure, duration of statin use, cholesterolyear score and CAC score. After adjustment for all significant covariables, plasma Lp(a) concentration remained a significant predictor of AVC, with an odds ratio per 10-mg dL1 increase in Lp(a) concentration of 1.11 (95% confidence interval 1.01– 1.20, P = 0.03). Conclusion In asymptomatic statin-treated FH patients, plasma Lp(a) concentration is an independent risk indicator for AVC. Keywords • aortic valve calcification, asymptomatic • coronary artery calcification • familial hypercholesterolaemia • lipoprotein(a)