{"id":"a0327444ecee","type":"article","url":"https://hartvaat.nl/2026/04/01/verhoogd-lp-a-hangt-samen-met-mitralisring-calcificatie-maar-niet-met-mitralisin/","title":"Verhoogd Lp(a) hangt samen met mitralisring-calcificatie maar niet met mitralisinsufficiëntie","title_en":"","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog"],"tags":["bloeddrukbehandeling","mitralisinsufficiëntie","tricuspidalisinsufficiëntie"],"journal":"Journal of clinical lipidology","doi":"10.1016/j.jacl.2026.03.022","source_url":"https://doi.org/10.1016/j.jacl.2026.03.022","authors":["Daoud Eldawud","Md Fahim","Keston Rattan","Omar Alwahadneh","Peter Khouri","Louis Salciccioli"],"significance":5,"published":"2026-04-30","source_date":"2026-04-01","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/"],"congress":"","summary_en":"A retrospective TriNetX cohort study (>130,000 adults with Lp(a) measurements, propensity-matched into 66,292 pairs) found that elevated Lp(a) (>50 mg/dL) was independently associated with mitral annular calcification (HR 1.33) and — as positive control — with aortic stenosis (HR 1.31). No significant association was seen with mitral regurgitation, mitral stenosis or mitral valve prolapse. The findings extend Lp(a)'s role in calcific valvular disease and call for prospective studies.","created":"2026-07-03T10:32:49Z","updated":"2026-07-03T13:31:45Z","licence":"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.","body_markdown":"Retrospectieve TriNetX-cohortanalyse (>130.000 volwassenen met Lp(a)-bepalingen, 1:1 propensity-gematcht in 66.292 paren) toont dat verhoogd Lp(a) (>50 mg/dL) onafhankelijk geassocieerd is met mitralisring-calcificatie (HR 1,33) en met aortastenose als positieve controle (HR 1,31). Geen significante associatie met mitralisinsufficiëntie, mitralisstenose of mitralisklepprolaps. De bevindingen breiden de rol van Lp(a) in calcificerende klepziekte verder uit en pleiten voor prospectieve studies.","abstract_original":"BACKGROUND: Lipoprotein(a) [Lp(a)] is a genetically determined cardiovascular risk factor increasingly linked to calcific valvular disease. Although its role in aortic stenosis is well established, the association between Lp(a) and mitral valve pathology, particularly mitral annular calcification (MAC), mitral stenosis (MS), and mitral regurgitation (MR), remains uncertain. OBJECTIVE: To evaluate the association between elevated Lp(a) levels and mitral valve disease in a large, real-world cohort. METHODS: We conducted a retrospective observational analysis using the TriNetX research network, including over 130,000 adults with available Lp(a) measurements. Patients with Lp(a) >50 mg/dL were propensity score matched 1:1 to those with Lp(a) <50 mg/dL across 54 demographic, clinical, and treatment variables. Valvular outcomes were defined using administrative codes. Kaplan-Meier survival estimates and log-rank tests were calculated in the matched cohorts. The primary outcome was MAC, with MR, MS, and mitral valve prolapse (MVP) as secondary outcomes. AS served as a positive control. RESULTS: Each matched cohort included 66,292 patients. Elevated Lp(a) was significantly associated with the primary outcome of MAC (hazard ratio [HR] 1.330, 95% CI 1.172-1.509, P < .001). The positive control outcome of AS(Aortic stenosis) was also significant (HR 1.313, 95% CI 1.175-1.466, P < .001). No significant associations were observed for the secondary outcomes of MR (HR 1.006, 95% CI 0.940-1.077, P = .856), MS (HR 1.178, 95% CI 0.875-1.587, P = .280), or MVP (HR 1.035, 95% CI 0.863-1.241, P = .710). CONCLUSION: In this large multicenter propensity-matched cohort, elevated Lp(a) was independently associated with MAC but not with MS, MR, or mitral valve prolapse. These findings support a potential role of Lp(a) in mitral annular calcification and highlight the need for prospective studies to clarify causality and clinical implications."}