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Lipoprotein(a) immunoassays and their associations with coronary artery calcification and aortic valve calcification - 08/03/25

Doi : 10.1016/j.ahj.2025.02.008 
Maarten J.G. Leening, MD, PhD, FESC a, b, c, , Ching F. Khan, MD, MSc b, d, Fang Zhu, MPH, PhD c, Sunny S. Singh, MD, PhD e, f, Maryam Kavousi, MD, PhD, FESC c, Eric J.G. Sijbrands, MD PhD e, Yolanda B. de Rijke, PhD g, #, Daniel Bos, MD, PhD b, c, h, i, #
a Department of Cardiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands 
b Department of Radiology and Nuclear Medicine, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands 
c Department of Epidemiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands 
d Department of Neurology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands 
e Department of Internal Medicine, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands 
f Department of Internal Medicine, Reinier de Graaf Hospital, Delft, The Netherlands 
g Department of Clinical Chemistry, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands 
h Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 
i Department of Cardiovascular Sciences, KU Leuven, Faculty of Medicine, Leuven, Belgium 

Reprint requests: Maarten J.G. Leening, MD, PhD, FESC, Department of Epidemiology (Na-2710), Erasmus MC – University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.Department of Epidemiology (Na-2710)Erasmus MC – University Medical Center RotterdamPO Box 2040Rotterdam3000 CAThe Netherlands

ABSTRACT

Background

Lp(a) causes atherosclerosis and degenerative aortic valve disease, but concerns have risen that mass-based assays may beaffected by isoform sizes and provide inaccurate estimates of Lp(a) exposure.

Methods

We compared contemporary immunoturbidimetric assays reporting either mass-based (Randox) or molar-based (Roche) using data from 5,129 unselected participants from the prospective population-based Rotterdam Study cohort. We studied the association of both Lp(a) measurements with the burden of coronary artery calcium (CAC) and aortic valve calcification (AVC) in a random subset of participants who underwent cardiac CT.

Results

There was a near perfect linear correlation between Lp(a) concentrations from both immunoassays (R2 98.8%) with most pronounced differences apparent only at very high Lp(a) concentrations. Lp(a) concentrations were related with natural logtransformed Agatston scores (Randox standardized linear β 0.1003, P = 5.6·10−8; Roche standardized linear β 0.1004, P = 5.4·10−8). Lp(a) concentrations were strongly but similarly related to natural log-transformed AVC Agatston scores (Randox standardized linear β 0.1525, P = 9.2·10−16; Roche standardized linear β 0.1539, P = 4.8·10−16).

Conclusion

We demonstrate that these immunoassays provide interchangeable Lp(a) measurements, and that associations with CAC and AVC were near-identical. This provides opportunities to directly compare findings from research done with either immunoassay.

Trial Registration

The Rotterdam Study has been entered in the Netherlands National Trial Register and the WHO International Clinical Trials Registry Platform under shared catalog number NTR6831.

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P. 42-46 - Giugno 2025 Ritorno al numero
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