Lipoprotein(a) (Lp[a]) is the preferential lipoprotein carrier
of oxidized phospholipids (OxPLs) and a well-established genetic
risk factor for calcific aortic valve stenosis (CAVS). Whether Lp(a)
predicts aortic valve microcalcification in individuals without CAVS is
unknown. Our objective was to estimate the prevalence of Lp(a) and
OxPL levels in patients with CAVS by using 2 echocardiography laboratories and to determine if individuals with elevated Lp(a) but without CAVS have higher aortic valve microcalcification.
Methods: We recruited 282 patients with CAVS and 108 controls from Quebec City, Canada. In a second group of individuals with high (>75 nmol/L, n = 27) or low (<75nmol/L, n = 28) Lp(a) levels, 18F-sodium fluoride positron emission tomography/computed tomography was performed to determine the difference in mean tissue-to-background ratio (TBR) of the aortic valve.
Results: Patients with CAVS had higher Lp(a), higher OxPL-apolipoprotein-B , and higher OxPL-apolipoprotein(a) levels compared with individuals
without CAVS (all P < 0.0001). Individuals without CAVS but elevated
Lp(a) had 40% higher mean TBR compared with individuals with low
Lp(a) levels (mean TBR ¼ 1.25 ± 0.23 vs 1.15 ± 0.11, P = 0.02).
Conclusions: Elevated Lp(a) and OxPL levels are associated with prevalent
CAVS in patients studied in an echocardiography laboratory setting. In
patients with elevated Lp(a), evidence of aortic valvemicrocalcification by
18F-sodium fluoride positron emission tomography/computed tomography is present before the development of clinically manifested CAVS.

01 - LIPOPROTEIN(A), OXIDIZED PHOSPHOLIPIDS, AND AORTIC VALVE MICROCALCIFICATION ASSESSED BY 18F-NAF PET/CT