| Title | Interaction of age with lipoproteins as predictors of aortic valve calcification in the multi-ethnic study of atherosclerosis. | | Author(s) | Owens DS, Katz R, Johnson E, Shavelle DM, Probstfield JL, Takasu J, Crouse JR, Carr JJ, Kronmal R, Budoff MJ, O'Brien KD | | Institution | Division of Cardiology, Department of Internal Medicine, University of Washington, 1959 NE Pacific St, Seattle, WA 98195-6422, USA. | | Source | Arch Intern Med 2008 Jun 9; 168(11):1200-7. | | MeSH | Age Factors
Aged
Aged, 80 and over
Aortic Valve Stenosis
Atherosclerosis
Calcinosis
Chi-Square Distribution
Cholesterol, LDL
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Prevalence
Questionnaires
Regression Analysis
Severity of Illness Index
United States
| | Abstract | 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. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, N.I.H., Extramural
| | PubMed ID | 18541828 |
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