Lipoprotein (a) and aortic valve calcium in South Asians compared to other race/ethnic groups

Minhal Makshood, Parag H. Joshi, Alka M. Kanaya, Colby Ayers, Matthew Budoff, Michael Y. Tsai, Michael Blaha, Erin D. Michos, Wendy S. Post

Research output: Contribution to journalArticlepeer-review

Abstract

Background and aims: South Asians are at increased risk for cardiovascular disease (CVD). Aortic valve calcium (AVC) is associated with CVD risk and aortic stenosis. Elevated Lp(a) is a heritable risk factor for CVD and AVC. AVC prevalence and its association with Lp(a) have not been studied in South Asians. Methods: Among participants in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (n = 695), AVC prevalence and extent were compared to four race/ethnic groups in the Multi-Ethnic Study of Atherosclerosis (MESA) (n = 4671). Multivariable regression was performed to evaluate associations between Lp(a) and AVC stratified by race/ethnic groups, adjusting for cardiovascular risk factors. Results: After age and sex adjustment, South Asians had higher median Lp(a) (17.0 mg/dL) compared to Whites (12.9 mg/dL), Hispanics (13.1 mg/dL) and Chinese Americans (12.9 mg/dL), and Blacks had highest Lp(a) levels (35.1 mg/dL). There were no differences in the odds of AVC in South Asians compared with Whites or Hispanics, after age and sex adjustment (p = 0.64 and 0.63, respectively). Odds of AVC was lower in Chinese (OR 0.35; 95%CI 0.23–0.54) and somewhat lower in Blacks compared with South Asians (OR 0.76; 0.56–1.04). There were no associations between Lp(a) and AVC presence or extent in South Asians. Lp(a) was associated with AVC only among Blacks and Whites. Conclusions: Although present in Whites and Blacks, there were no associations between Lp(a) and AVC in South Asians. These differences may be due to statistic power or race specific modifying factors that influences the effect of Lp(a) particles on AVC pathogenesis.

Original languageEnglish (US)
Pages (from-to)14-19
Number of pages6
JournalAtherosclerosis
Volume313
DOIs
StatePublished - Nov 2020

Bibliographical note

Funding Information:
The MASALA study was supported by the NIH grant no. 1R01HL093009 , 2R01HL093009 , and R01 HL120725 . Data collection at UCSF was also supported by NIH/NCRR UCSF-CTSI grant number UL1 RR024131 . Lp(a) measurements were supported by the Cliff Lede Family Charitable Foundation.

Funding Information:
Parag Joshi: Grant support: AHA , NovoNordisk, NASA; consulting: Regeneron , Bayer; Equity—G3 Therapeutics; Site investigator (funds to institution): Novartis , AstraZeneca . Michael Blaha: Grants: NIH , FDA , AHA , Aetna Foundation , Amgen Foundation; advisory boards: Amgen , Sanofi , Regeneron , Novartis , Novo Nordisk , Bayer , Akcea; consulting: Zogenix , Tricida, Gilead; executive committee: HORIZONSLp(a) – Novartis . Matthew Budoff: Grants: General electric. The other authors have nothing to disclose.

Funding Information:
The MASALA study was supported by the NIH grant no. 1R01HL093009, 2R01HL093009, and R01 HL120725. Data collection at UCSF was also supported by NIH/NCRR UCSF-CTSI grant number UL1 RR024131. Lp(a) measurements were supported by the Cliff Lede Family Charitable Foundation.The MESA research was supported by R01 HL071739 and contracts 75N92020D00001, HHSN268201500003I, N01-HC-95159, 75N92020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92020D00003, N01-HC-95162, 75N92020D00006, N01-HC-95163, 75N92020D00004, N01-HC-95164, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169 from the National Heart, Lung, and Blood Institute, and by grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National Center for Advancing Translational Sciences (NCATS). The authors thank the other investigators, the staff, and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org.Parag Joshi: Grant support: AHA, NovoNordisk, NASA; consulting: Regeneron, Bayer; Equity?G3 Therapeutics; Site investigator (funds to institution): Novartis, AstraZeneca. Michael Blaha: Grants: NIH, FDA, AHA, Aetna Foundation, Amgen Foundation; advisory boards: Amgen, Sanofi, Regeneron, Novartis, Novo Nordisk, Bayer, Akcea; consulting: Zogenix, Tricida, Gilead; executive committee: HORIZONSLp(a) ? Novartis. Matthew Budoff: Grants: General electric. The other authors have nothing to disclose.

Funding Information:
The MESA research was supported by R01 HL071739 and contracts 75N92020D00001 , HHSN268201500003I , N01-HC-95159 , 75N92020D00005 , N01-HC-95160 , 75N92020D00002 , N01-HC-95161 , 75N92020D00003 , N01-HC-95162 , 75N92020D00006 , N01-HC-95163 , 75N92020D00004 , N01-HC-95164 , 75N92020D00007 , N01-HC-95165 , N01-HC-95166 , N01-HC-95167 , N01-HC-95168 and N01-HC-95169 from the National Heart, Lung, and Blood Institute , and by grants UL1-TR-000040 , UL1-TR-001079 , and UL1-TR-001420 from the National Center for Advancing Translational Sciences (NCATS) . The authors thank the other investigators, the staff, and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org .

Publisher Copyright:
© 2020 Elsevier B.V.

Keywords

  • Aortic valve calcium
  • Lipoprotein (a)
  • MASALA
  • South asians

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