BACKGROUND AND AIM OF THE STUDY: Aortic valve calcification (AVC) is a common condition that is found predominantly in the elderly. Clinical and histopathologic data prove that AVC is an active, progressive disease involving an atherosclerotic process. The possible role of novel coronary risk factors in the development of AVC were evaluated. METHODS: A total of 285 consecutive patients (age >60 years) who had been admitted to the authors' cardiology outpatient clinic was enrolled. Each patient underwent two-dimensional Doppler echocardiography. Serum levels of lipoprotein(a) (Lp(a)), homocysteine (Hcy), uric acid and C-reactive protein (CRP) were monitored and compared between patients with AVC and subjects with otherwise normal aortic valve morphology. RESULTS: AVC was detected in 112 patients. Compared to controls, patients with AVC were significantly older (73.0 +/- 7.4 versus 68.5 +/- 6.7 years; p <0.0001) and, in addition to higher dyslipidemia, had significantly higher serum levels of Lp(a) (27.4 (range: 13.0-47.5) versus 19.9 (range: 10.7-36.1) mg/dl; p = 0.033) and CRP (6.7 (4.5-10.2) versus 5.6 (3.9-8.0) mg/l; p = 0.008). Serum Hcy and uric acid levels were similar between the groups. Multivariate analysis identified age and serum levels of Lp(a) or CRP as independent determinants of AVC. CONCLUSION: AVC is common in elderly patients admitted to cardiology clinics. In addition to advanced age, high serum levels of Lp(a) and CRP are independent predictors of the condition.
BACKGROUND AND AIM OF THE STUDY: Aortic valve calcification (AVC) is a common condition that is found predominantly in the elderly. Clinical and histopathologic data prove that AVC is an active, progressive disease involving an atherosclerotic process. The possible role of novel coronary risk factors in the development of AVC were evaluated. METHODS: A total of 285 consecutive patients (age >60 years) who had been admitted to the authors' cardiology outpatient clinic was enrolled. Each patient underwent two-dimensional Doppler echocardiography. Serum levels of lipoprotein(a) (Lp(a)), homocysteine (Hcy), uric acid and C-reactive protein (CRP) were monitored and compared between patients with AVC and subjects with otherwise normal aortic valve morphology. RESULTS: AVC was detected in 112 patients. Compared to controls, patients with AVC were significantly older (73.0 +/- 7.4 versus 68.5 +/- 6.7 years; p <0.0001) and, in addition to higher dyslipidemia, had significantly higher serum levels of Lp(a) (27.4 (range: 13.0-47.5) versus 19.9 (range: 10.7-36.1) mg/dl; p = 0.033) and CRP (6.7 (4.5-10.2) versus 5.6 (3.9-8.0) mg/l; p = 0.008). Serum Hcy and uric acid levels were similar between the groups. Multivariate analysis identified age and serum levels of Lp(a) or CRP as independent determinants of AVC. CONCLUSION: AVC is common in elderly patients admitted to cardiology clinics. In addition to advanced age, high serum levels of Lp(a) and CRP are independent predictors of the condition.
Authors: George Thanassoulis; Catherine Y Campbell; David S Owens; J Gustav Smith; Albert V Smith; Gina M Peloso; Kathleen F Kerr; Sonali Pechlivanis; Matthew J Budoff; Tamara B Harris; Rajeev Malhotra; Kevin D O'Brien; Pia R Kamstrup; Børge G Nordestgaard; Anne Tybjaerg-Hansen; Matthew A Allison; Thor Aspelund; Michael H Criqui; Susan R Heckbert; Shih-Jen Hwang; Yongmei Liu; Marketa Sjogren; Jesper van der Pals; Hagen Kälsch; Thomas W Mühleisen; Markus M Nöthen; L Adrienne Cupples; Muriel Caslake; Emanuele Di Angelantonio; John Danesh; Jerome I Rotter; Sigurdur Sigurdsson; Quenna Wong; Raimund Erbel; Sekar Kathiresan; Olle Melander; Vilmundur Gudnason; Christopher J O'Donnell; Wendy S Post Journal: N Engl J Med Date: 2013-02-07 Impact factor: 91.245