%0 Journal Article
%T Lipoprotein(a) in Patients Undergoing Transcatheter Aortic Valve Replacement
%A Anthony N. DeMaria
%A Bruno Cotter
%A Calvin Yeang
%A Ehtisham Mahmud
%A Gary S. Ma
%A Michael J. Wilkinson
%A Mitul Patel
%A Ryan R. Reeves
%A Sotirios Tsimikas
%J Angiology
%@ 1940-1574
%D 2019
%R 10.1177/0003319719826461
%X Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for calcific aortic valve stenosis (CAVS) for which transcatheter aortic valve replacement (TAVR) is increasingly utilized as treatment. We evaluated the effect of a program to increase testing of and define the prevalence of elevated Lp(a) among patients undergoing TAVR. Educational efforts and incorporation of a ˇ°check-boxˇ± Lp(a) order to the preoperative TAVR order set were instituted. Retrospective chart review was performed in 229 patients requiring TAVR between May 2013 and September 2018. Of these patients, 57% had an Lp(a) level measured; testing rates increased from 0% in 2013 to 96% in 2018. Lipoprotein(a) testing occurred in 11% of patients before and in 80% of patients after the ˇ°check-boxˇ± order set (P < .001). The prevalence of elevated Lp(a) (ˇÝ30 mg/dL) was 35%; these patients had a higher incidence of coronary artery disease requiring revascularization compared with patients with normal Lp(a) (65% vs 47%; P = .047). Patients with Lp(a) ˇÝ30 mg/dL also had higher incidence of paravalvular leak compared with those with normal Lp(a) (13% vs 4%; P = .04). This study defines the prevalence of elevated Lp(a) in advanced stages of CAVS and provides a practice pathway to assess procedural complications and long-term outcomes of TAVR in patients with elevated Lp(a) levels
%K lipoprotein(a)
%K calcified aortic valve stenosis
%K TAVR
%U https://journals.sagepub.com/doi/full/10.1177/0003319719826461