RT Journal Article
SR Electronic
T1 Association between plasma lipoprotein levels and bioprosthetic valve structural degeneration
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1915
OP 1921
DO 10.1136/heartjnl-2016-309541
VO 102
IS 23
A1 Mohamed Jalloul Nsaibia
A1 Ablajan Mahmut
A1 Haifa Mahjoub
A1 Abdellaziz Dahou
A1 Rihab Bouchareb
A1 Marie-Chloé Boulanger
A1 Jean-Pierre Després
A1 Yohan Bossé
A1 Benoît J Arsenault
A1 Eric Larose
A1 Philippe Pibarot
A1 Patrick Mathieu
YR 2016
UL http://heart.bmj.com/content/102/23/1915.abstract
AB Introduction Structural valve degeneration (SVD) leads to the failure of aortic valve bioprostheses. It is suspected that lipid-derived factors could play a role in SVD. We hypothesised that oxidised low-density lipoprotein (OxLDL), OxLDL/LDL, OxLDL/high-density lipoprotein (OxLDL/HDL) and proprotein convertase subtilisin/kexin 9 (PCSK9) may be associated with SVD.Methods We included 199 patients who underwent an aortic valve replacement with a bioprosthesis and had an echocardiography follow-up to evaluate the function of the prosthesis. SVD was defined as an increase in mean transprosthetic gradient (≥10 mm Hg) or a worsening of transprosthetic regurgitation (≥1/3) during the follow-up.Results After a mean follow-up of 8±3.5 years, 41(21%) patients developed SVD. The univariate predictors of SVD were LDL (p=0.03), apolipoprotein B (p=0.01), OxLDL (p=0.02), OxLDL/HDL (p=0.009) and LDL associated with small, dense particles (LDL-C<255Å) (p=0.02). In a model adjusted for covariates, only OxLDL/HDL (OR 1.49, 95%CI 1.08 to 2.07 per 10 units, p=0.01) remained associated with SVD. There was a significant interaction between OxLDL/HDL and PCSK9 on SVD (p=0.05). After adjustment, compared with patients with low OxLDL/HDL (median, <25.4) and low PCSK9 (median, <298 ng/mL) (referent), patients with both an elevated OxLDL/HDL ratio and PCSK9 had a higher risk of SVD (OR 2.93, 95% CI 1.02 to 9.29, p=0.04).Conclusions OxLDL/HDL ratio is independently associated with SVD.