Severe aortic stenosis can be treated with transcatheter aortic valve implantation (TAVI). There is emerging evidence suggesting that high lipoprotein(a) [Lp(a)] levels may be associated with worse ou Show more
Severe aortic stenosis can be treated with transcatheter aortic valve implantation (TAVI). There is emerging evidence suggesting that high lipoprotein(a) [Lp(a)] levels may be associated with worse outcomes after TAVI. To compare major adverse cardiac and cerebrovascular events (MACCE) within 12 months after TAVI and long-term survival between patients with high and low Lp(a) levels. In this prospective, multicenter cohort study we included patients with severe aortic stenosis qualified for TAVI with stored plasma available for Lp(a) measurement. Patients were stratified into high and low Lp(a) groups (cutoff 30 mg/dL). Two primary end points were analyzed: (i) 12-month MACCE, and (ii) long-term overall survival. Secondary end points were individual components of MACCE. Between November 2018 and September 2021, TAVI was performed across 3 clinical sites; stored plasma was available for Lp(a) measurement in 82 patients. We observed no difference in MACCE occurrence between high and low Lp(a) groups. In unadjusted analyses, patients with elevated Lp(a) had worse long-term survival during a median follow-up of 2.8 years (log-rank P = 0.045) but this difference lost significance after adjustments for age and sex in a Cox regression model (hazard ratio, 2.85; 95% CI, 0.85 to 9.55, P = 0.054). None of the secondary end points differed significantly between the groups. Patients with elevated Lp(a) have a comparable risk of 12-month MACCE after TAVI to those with low Lp(a) but might have worse long-term survival. Long-term findings should be considered exploratory and requires further confirmation. Show less