High-Density Lipoprotein and Long-Term Incidence and Progression of Aortic Valve Calcification: The Multi-Ethnic Study of Atherosclerosis
High-Density Lipoprotein and Long-Term Incidence and Progression of Aortic Valve Calcification: The Multi-Ethnic Study of Atherosclerosis
Background: Aortic valve calcification (AVC) shares pathological features with atherosclerosis. Lipoprotein components have been detected in aortic valve tissue, including HDL (high-density lipoprotein). HDL measures have inverse associations with cardiovascular disease, but relationships with long-term AVC progression are unclear. We investigated associations of HDL cholesterol, HDL-particle number and size, apoC3-defined HDL subtypes, and, secondarily, CETP (cholesteryl ester transfer protein) mass and activity, with long-term incidence and progression of AVC. Methods: We used linear mixed-effects models to evaluate the associations of baseline HDL indices with AVC. AVC was quantified by Agatston scoring of up to 3 serial computed tomography scans over a median of 8.9 (maximum 11.2) years of follow-up in the Multi-Ethnic Study of Atherosclerosis (n=6784). Results: After adjustment, higher concentrations of HDL-C (high-density lipoprotein cholesterol), HDL-P (HDL particles), large HDL-P, and apoC3-lacking HDL-C were significantly associated with lower incidence/progression of AVC. Neither small or medium HDL-P nor apoC3-containing HDL-C was significantly associated with AVC incidence/progression. When included together, a significant association was observed only for HDL-C, but not for HDL-P. Secondary analyses showed an inverse relationship between CETP mass, but not activity, and AVC incidence/progression. In exploratory assessments, inverse associations for HDL-C, HDL-P, large HDL-P, and apoC3-lacking HDL with AVC incidence/progression were more pronounced for older, male, and White participants. ApoC3-containing HDL-C only showed a positive association with AVC in these subgroups. Conclusions: In a multiethnic population, HDL-C, HDL-P, large HDL-P, and apoC3-lacking HDL-C were inversely associated with long-term incidence and progression of AVC. Further investigation of HDL composition and mechanisms could be useful in understanding pathways that slow AVC.
- Los Angeles County Department of Health Services United States
- Los Angeles Biomedical Research Institute United States
- University of Minnesota Morris United States
- Brigham and Women's Faulkner Hospital United States
- University of Parma Italy
Male, Aging, HDL, Lipoproteins, Clinical Sciences, cholesteryl ester transfer protein, 610, Clinical sciences, Cardiorespiratory Medicine and Haematology, Cardiovascular, Cardiovascular medicine and haematology, cardiovascular disease, Cardiovascular Medicine and Haematology, 616, Humans, Biomedical and Clinical Sciences, Incidence, lipoprotein, Cholesterol, HDL, cholesterol, Calcinosis, Aortic Valve Stenosis, Atherosclerosis, Cholesterol Ester Transfer Proteins, Heart Disease, Cholesterol, Cardiovascular System & Hematology, Aortic Valve, incidence, Lipoproteins, HDL
Male, Aging, HDL, Lipoproteins, Clinical Sciences, cholesteryl ester transfer protein, 610, Clinical sciences, Cardiorespiratory Medicine and Haematology, Cardiovascular, Cardiovascular medicine and haematology, cardiovascular disease, Cardiovascular Medicine and Haematology, 616, Humans, Biomedical and Clinical Sciences, Incidence, lipoprotein, Cholesterol, HDL, cholesterol, Calcinosis, Aortic Valve Stenosis, Atherosclerosis, Cholesterol Ester Transfer Proteins, Heart Disease, Cholesterol, Cardiovascular System & Hematology, Aortic Valve, incidence, Lipoproteins, HDL
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