Association Of Aortic Valve Calcification And High Levels Of Lipoprotein (a). A Meta-analysis

Background: Some studies reported a positive link between high levels of lipoprotein (a) and aortic valve calcification. The aim of this study is to perform a meta-analysis to find whether aortic valve calcification has a significant association with high levels of lipoprotein (a). Methods: We searched PUBMED, WOS and OVID databases. We included cohort studies or clinical trials that measured lipoprotein (a) levels in patients with aortic valve calcium and controls without aortic valve calcium. Case reports, editorials and animal studies were excluded. RevMan software (5.4) was used to perform the meta-analysis. Levels of lipoprotein (a) and number of patients with increased levels of lipoprotein (a) outcomes were presented as standardized mean difference (SMD) and Odds ratio (OR) with 95% confidence interval (CI). Results: After complete screening, 7 studies were included with a total number of 446179 patients included in the analysis. The pooled analysis showed a statistically significant association between incidence of aortic valve calcium and increased levels of lipoprotein (a) compared with controls (SMD = 1.71, 95% CI = 1.04 to 2.38, p-value < 0.00001). The pooled analysis showed a statistically significant association between incidence of aortic valve calcium and increased number of patients with high levels of lipoprotein (a) compared with controls (OR = 2.21, 95% CI = 1.26 to 3.87, p-value = 0.006). We observed a significant heterogeneity in both outcomes ( P < 0.00001) that was not solved by subgroup analysis or leave-one out test. Conclusion: This meta-analysis showed a statistically significant association between incidence of aortic valve calcium and increased levels of lipoprotein (a) compared with controls. Patients with high levels of lipoprotein (a) are at increased risk of developing aortic valve calcification. Medications targeting lipoprotein (a) in future clinical trials may be useful in primary prevention of aortic valve calcification in high risk patients.