# Aspirine, lipoproteïne(a) en aortaklepstenose: de MESA-studie

*geplaatst 2026-02-21 · Cholesterol · European heart journal · doi 10.1093/eurheartj/ehag018 · https://hartvaat.nl/2026/02/21/aspirine-lipoproteine-a-en-aortaklepstenose-de-mesa-studie/*

In de Multi-Ethnic Study of Atherosclerosis werd onderzocht of aspirinegebruik de incidentie van aortaklepcalcificatie en -stenose beïnvloedt bij verschillende niveaus van Lp(a) en LDL-C. Lp(a) heeft antifibrinolytische eigenschappen, waardoor aspirine mogelijk extra bescherming biedt bij hoog Lp(a).

## English: Aspirin use, lipoprotein(a), and calcific aortic valve disease: the Multi-ethnic Study of Atherosclerosis.

This MESA study examined the relationship between aspirin use, lipoprotein(a) levels, and calcific aortic valve disease, exploring whether aspirin modifies the Lp(a)-driven pathway to aortic stenosis.

## Abstract (original, from the publication)

BACKGROUND AND AIMS: Lipoprotein(a) [Lp(a)] and LDL cholesterol (LDL-C) are causally linked to aortic valve calcium (AVC) and aortic stenosis (AS). Lipoprotein(a) has anti-fibrinolytic properties; therefore, aspirin may reduce cardiovascular disease risk among individuals with high Lp(a). This analysis sought to determine the association of aspirin with incident AVC and AS across Lp(a) and LDL-C levels. METHODS: This observational study included up to 6598 participants in the Multi-Ethnic Study of Atherosclerosis. Aortic valve calcium was measured on non-contrast cardiac computed tomography. Multivariable Cox hazards regression assessed the association of self-reported regular aspirin use (≥3 days/week) with incident AVC and severe AS, stratified by Lp(a) and LDL-C. Aortic valve calcium and Lp(a) values were not reported to participants. RESULTS: Mean age was 62 years, 53% were women, 23% reported regular aspirin use, 8% developed AVC (median 8.9 years), and 1% developed severe AS (median 16.7 years). Among individuals with elevated Lp(a), regular aspirin use was associated with a lower risk of incident AVC (Lp(a) ≥75 mg/dL: hazard ratio (HR) .42, 95% confidence interval (CI) .19-.93; Lp(a) ≥100 mg/dL: HR .17, 95% CI .04-.67) and severe AS (Lp(a) ≥50 mg/dL: HR .13, 95% CI: .04-.47; Lp(a) ≥75 mg/dL: HR .02, 95% CI .001-.29). For participants with elevated LDL-C, there was no association of regular aspirin use with incident AVC (LDL-C ≥130 mg/dL: HR 1.02, 95% CI .66-1.58; LDL-C ≥160 mg/dL: HR 1.51, 95% CI .53-4.28) or severe AS (LDL-C ≥100 mg/dL: HR .70, 95% CI .39-1.26; LDL-C ≥130 mg/dL: HR .46, 95% CI .14-1.47). CONCLUSIONS: In this exploratory analysis of prospective observational cohort data, regular aspirin use was associated with a lower risk of AVC and severe AS in persons with high Lp(a), but not high LDL-C. Confirmatory studies are required to determine the role of aspirin in the prevention of AVC and AS for persons with high Lp(a).

Auteurs: Alexander C Razavi, Harpreet S Bhatia, Natalie Marrero, Omar Dzaye, Wendy S Post, Khurram Nasir, Michael Tsai, Viola Vaccarino, Ramachandran S Vasan, George Thanassoulis, Sotirios Tsimikas, Laurence S Sperling, Matthew J Budoff, Roger S Blumenthal, Michael J Blaha, Seamus P Whelton

---
Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehag018. Bijgewerkt 2026-07-03T13:24:33Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.