Lipoprotein(a) and Body Mass Compound the Risk of Calcific Aortic Valve Disease

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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%.

OriginalsprogEngelsk
TidsskriftJournal of the American College of Cardiology
Vol/bind79
Udgave nummer6
Sider (fra-til)545-558
Antal sider14
ISSN0735-1097
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
This work was supported by Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; the Novo Nordisk Foundation (grant NNF18OC0052893), Denmark; and Chief Physician Johan Boserup and Lise Boserup‘s Fund, Denmark. The Copenhagen General Population Study is supported by the Copenhagen County Foundation and Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark. Dr Kamstrup has served as a consultant for Silence Therapeutics. Dr Nordestgaard has served as a consultant and lecturer for AstraZeneca, Sanofi, Regeneron, Akcea, Amgen, Kowa, Denka, Amarin, Novartis, Novo Nordisk, Silence Therapeutics, and Esperion. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Publisher Copyright:
© 2022 American College of Cardiology Foundation

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