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Response to: Correspondence on "Lipoprotein(a) has no major impact on calcification activity in patients with mild to moderate aortic valve stenosis" by Pantelidis et al
  1. Yannick Kaiser1,
  2. Nick S Nurmohamed1,2,
  3. Erik S G Stroes1,
  4. S Matthijs Boekholdt3
  1. 1 Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
  2. 2 Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
  3. 3 Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Dr S Matthijs Boekholdt, Cardiology, Amsterdam UMC Locatie AMC, Amsterdam, Noord Holland, Netherlands; s.m.boekholdt{at}amsterdamumc.nl

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The Authors’ reply

Pantelidis1 raises several points regarding our manuscript ‘Lipoprotein(a) has no major impact on calcification activity in patients with mild to moderate aortic valve stenosis’. 2 He states that our study results should be interpreted with caution, due to (1) selection bias, (2) the absence of follow-up data and (3) a small sample size.

First and foremost, it is important to state that there is irrefutable evidence from genetic and population studies supporting a causal role of lipoprotein(a) (Lp(a)) in the pathophysiology of aortic valve stenosis (AVS).3–5 Our recently published data do not refute this evidence, but rather suggest that the relative impact of Lp(a) on calcification activity may decrease as the valvular calcium burden grows.

The first comment by Pantelidis involves selection bias by only selecting patients with mild to moderate AVS, while excluding more advanced AVS. Please note that the previous ‘discrepant’ studies6 7 also limited patient inclusion to mild to moderate AVS. Our reason for not including severe …

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Footnotes

  • Contributors All authors have contributed to the manuscript.

  • 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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