BACKGROUND: Previous epidemiologic studies have shown that low-density lipoprotein is an independent risk factor for prevalent aortic valve calcification (AVC); however, to our knowledge, the interactions between plasma lipoprotein concentrations and age on the relative risks (RRs) for AVC prevalence and severity have not been examined in a large, racially and ethnically diverse cohort. METHODS: Using stepwise RR regression, the relationships of baseline fasting lipid levels and lipoprotein levels to baseline prevalence and severity of AVC were determined in 5801 non-statin-using participants in the Multi-Ethnic Study of Atherosclerosis (MESA). RESULTS: In age-stratified, adjusted analyses, the low-density lipoprotein-associated RRs (95% confidence intervals) for prevalent AVC were higher for younger compared with older participants (age 45-54 years, 1.69 [1.19-2.39]; age 55-64 years, 1.48 [1.24-1.76]; age 65-74 years, 1.09 [0.95-1.25]; and age 75-84 years, 1.16 [0.99-1.36]; P interaction = .04]. There was a similar, significant interaction of age with total cholesterol-associated RR for prevalent AVC (P interaction = .04). In contrast, total- to high-density lipoprotein cholesterol ratio RRs were similar across all age strata (P interaction = .68). At multivariate analyses, no lipoprotein parameter was associated with AVC severity. CONCLUSIONS: In this racially and ethnically diverse, preclinical cohort, low-density lipoprotein was a risk factor for AVC only in participants younger than 65 years, whereas the total cholesterol/high-density lipoprotein cholesterol ratio was associated with a modest increased risk of AVC across all ages. These findings may have important implications for the efficacy of and targets for dyslipidemia therapies in calcific aortic valve disease.
BACKGROUND: Previous epidemiologic studies have shown that low-density lipoprotein is an independent risk factor for prevalent aortic valve calcification (AVC); however, to our knowledge, the interactions between plasma lipoprotein concentrations and age on the relative risks (RRs) for AVC prevalence and severity have not been examined in a large, racially and ethnically diverse cohort. METHODS: Using stepwise RR regression, the relationships of baseline fasting lipid levels and lipoprotein levels to baseline prevalence and severity of AVC were determined in 5801 non-statin-using participants in the Multi-Ethnic Study of Atherosclerosis (MESA). RESULTS: In age-stratified, adjusted analyses, the low-density lipoprotein-associated RRs (95% confidence intervals) for prevalent AVC were higher for younger compared with older participants (age 45-54 years, 1.69 [1.19-2.39]; age 55-64 years, 1.48 [1.24-1.76]; age 65-74 years, 1.09 [0.95-1.25]; and age 75-84 years, 1.16 [0.99-1.36]; P interaction = .04]. There was a similar, significant interaction of age with total cholesterol-associated RR for prevalent AVC (P interaction = .04). In contrast, total- to high-density lipoprotein cholesterol ratio RRs were similar across all age strata (P interaction = .68). At multivariate analyses, no lipoprotein parameter was associated with AVC severity. CONCLUSIONS: In this racially and ethnically diverse, preclinical cohort, low-density lipoprotein was a risk factor for AVC only in participants younger than 65 years, whereas the total cholesterol/high-density lipoprotein cholesterol ratio was associated with a modest increased risk of AVC across all ages. These findings may have important implications for the efficacy of and targets for dyslipidemia therapies in calcific aortic valve disease.
Authors: J Jeffrey Carr; Jennifer Clark Nelson; Nathan D Wong; Michael McNitt-Gray; Yadon Arad; David R Jacobs; Stephan Sidney; Diane E Bild; O Dale Williams; Robert C Detrano Journal: Radiology Date: 2005-01 Impact factor: 11.105
Authors: Luis M Moura; Sandra F Ramos; José L Zamorano; Isabel M Barros; Luis F Azevedo; Francisco Rocha-Gonçalves; Nalini M Rajamannan Journal: J Am Coll Cardiol Date: 2007-01-22 Impact factor: 24.094
Authors: David M Shavelle; Junichuro Takasu; Matthew J Budoff; SongShou Mao; Xue Qiao Zhao; Kevin D O'Brien Journal: Lancet Date: 2002-03-30 Impact factor: 79.321
Authors: Jason P Linefsky; Kevin D O'Brien; Ronit Katz; Ian H de Boer; Eddy Barasch; Nancy S Jenny; David S Siscovick; Bryan Kestenbaum Journal: J Am Coll Cardiol Date: 2011-07-12 Impact factor: 24.094
Authors: J Gustav Smith; Kevin Luk; Christina-Alexandra Schulz; James C Engert; Ron Do; George Hindy; Gull Rukh; Line Dufresne; Peter Almgren; David S Owens; Tamara B Harris; Gina M Peloso; Kathleen F Kerr; Quenna Wong; Albert V Smith; Matthew J Budoff; Jerome I Rotter; L Adrienne Cupples; Stephen Rich; Sekar Kathiresan; Marju Orho-Melander; Vilmundur Gudnason; Christopher J O'Donnell; Wendy S Post; George Thanassoulis Journal: JAMA Date: 2014-11-05 Impact factor: 56.272
Authors: Sammy Elmariah; Joseph A C Delaney; David A Bluemke; Matthew J Budoff; Kevin D O'Brien; Valentin Fuster; Richard A Kronmal; Jonathan L Halperin Journal: JACC Cardiovasc Imaging Date: 2012-08
Authors: Jason Linefsky; Ronit Katz; Matthew Budoff; Jeffrey Probstfield; David Owens; Junichiro Takasu; David Shavelle; Pamela Ouyang; Bruce Psaty; Kevin D O'Brien Journal: Am J Cardiol Date: 2011-01 Impact factor: 2.778
Authors: Pathmaja Paramsothy; Ronit Katz; David S Owens; Gregory L Burke; Jeffrey L Probstfield; Kevin D O'Brien Journal: Am J Cardiol Date: 2009-12-22 Impact factor: 2.778