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Threshold effect for lipoprotein(a) in aortic stenosis
  1. Evangelos Tzolos,
  2. Marc Richard Dweck
  1. Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Professor Marc Richard Dweck, Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh EH8 9YL, UK; marc.dweck{at}

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Calcific aortic stenosis (AS) is the most common form of valvular heart disease in the Western world, and its healthcare burden is expected to double over the next 50 years.1 Currently, no medical therapy has demonstrated an ability to slow or halt progression of this common condition. While surgical or percutaneous aortic valve replacement is the only available treatment, important questions still remain with respect to the optimal timing of intervention, associated procedural risks and long-term durability. The quest to develop novel treatments to prevent or slow down AS, potentially removing the need for surgical intervention altogether, has not been successful up to now. Atherogenic apolipoprotein B-containing lipoproteins, like low-density lipoprotein (LDL) and lipoprotein(a) (Lp(a)), have been clearly implicated in the pathophysiology of AS, in particular in the initiation phase of the disease and with incident AS. However, multiple randomised clinical trials Simvastatin and Ezetimibe in Aortic Stenosis (SEAS), Scottish Aortic Stenosis and Lipid Lowering Trial, Impact in Regression (SALTIRE) and Aortic Stenosis Progression Observation: Measuring Effects of …

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  • Twitter @TzolosEvangelos, @MarcDweck

  • Contributors ET and MRD contributed to the drafting and revision of this editorial.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Commissioned; internally peer reviewed.

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