{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:08:16Z","timestamp":1789639696773,"version":"4.0.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,6,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Lipoprotein(a) (Lp(a)) is a potent causal risk factor for cardiovascular events and mortality. However, its relationship with subclinical atherosclerosis, as defined by arterial calcification, remains unclear. This study uses the ARIC (Atherosclerosis Risk in Communities Study) to evaluate the relationship between Lp(a) in middle age and measures of vascular and valvular calcification in older age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Lp(a) was measured at ARIC visit 4 (1996\u20131998), and coronary artery calcium (CAC), together with extracoronary calcification (including aortic valve calcium, aortic valve ring calcium, mitral valve calcification, and thoracic aortic calcification), was measured at visit 7 (2018\u20132019). Lp(a) was defined as elevated if &gt;50\u00a0mg\/dL and CAC\/extracoronary calcification were defined as elevated if &gt;100. Logistic and linear regression models were used to evaluate the association between Lp(a) and CAC\/extracoronary calcification, with further stratification by race. The mean age of participants at visit 4 was 59.2 (SD 4.3) years, with 62.2% women. In multivariable adjusted analyses, elevated Lp(a) was associated with higher odds of elevated aortic valve calcium (adjusted odds ratio [aOR], 1.82; 95% CI, 1.34\u20132.47), CAC (aOR, 1.40; 95% CI, 1.08\u20131.81), aortic valve ring calcium (aOR, 1.36; 95% CI, 1.07\u20131.73), mitral valve calcification (aOR, 1.37; 95% CI, 1.06\u20131.78), and thoracic aortic calcification (aOR, 1.36; 95% CI, 1.05\u20131.77). Similar results were obtained when Lp(a) and CAC\/extracoronary calcification were examined on continuous logarithmic scales. There was no significant difference in the association between Lp(a) and each measure of calcification by race or sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Elevated Lp(a) at middle age is significantly associated with vascular and valvular calcification in older age, represented by elevated CAC, aortic valve calcium, aortic valve ring calcium, mitral valve calcification, thoracic aortic calcification. Our findings encourage assessing Lp(a) levels in individuals with increased cardiovascular disease risk, with subsequent comprehensive vascular and valvular assessment where elevated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.121.024870","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T06:37:04Z","timestamp":1654238224000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":46,"title":["Lipoprotein(a) and Subclinical Vascular and Valvular Calcification on Cardiac Computed Tomography: The Atherosclerosis Risk in Communities Study"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7247-5257","authenticated-orcid":false,"given":"Olufunmilayo H.","family":"Obisesan","sequence":"first","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Baltimore MD"},{"name":"Medstar Union Memorial Hospital Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3885-4103","authenticated-orcid":false,"given":"Minghao","family":"Kou","sequence":"additional","affiliation":[{"name":"Tulane University School of Public Health and Tropical Medicine New Orleans LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4950-582X","authenticated-orcid":false,"given":"Frances M.","family":"Wang","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Boakye","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6710-9890","authenticated-orcid":false,"given":"Yasuyuki","family":"Honda","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M. Iftekhar","family":"Uddin","sequence":"additional","affiliation":[{"name":"Department of Medicine Brookdale University Hospital Medical Center Brooklyn NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9483-3510","authenticated-orcid":false,"given":"Omar","family":"Dzaye","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3901-0471","authenticated-orcid":false,"given":"Albert D.","family":"Osei","sequence":"additional","affiliation":[{"name":"Medstar Union Memorial Hospital Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6858-1057","authenticated-orcid":false,"given":"Olusola A.","family":"Orimoloye","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Nashville TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6537-3551","authenticated-orcid":false,"given":"Candace M.","family":"Howard\u2010Claudio","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center Jackson MS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4598-0669","authenticated-orcid":false,"given":"Josef","family":"Coresh","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Baltimore MD"},{"name":"Johns Hopkins Bloomberg School of Public Health Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1910-3168","authenticated-orcid":false,"given":"Roger S.","family":"Blumenthal","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2399-4653","authenticated-orcid":false,"given":"Ron C.","family":"Hoogeveen","sequence":"additional","affiliation":[{"name":"Department of Medicine Baylor College of Medicine Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9616-1946","authenticated-orcid":false,"given":"Matthew J.","family":"Budoff","sequence":"additional","affiliation":[{"name":"Los Angeles Biomedical Research Institute at Harbor\u2010UCLA Medical Center Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7179-718X","authenticated-orcid":false,"given":"Kunihiro","family":"Matsushita","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Baltimore MD"},{"name":"Johns Hopkins Bloomberg School of Public Health Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6432-1730","authenticated-orcid":false,"given":"Christie M.","family":"Ballantyne","sequence":"additional","affiliation":[{"name":"Department of Medicine Baylor College of Medicine Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5138-9683","authenticated-orcid":false,"given":"Michael J.","family":"Blaha","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-019-06906-9"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.03.061"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq386"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.06.051"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.01.070"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.R060582"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2016.11.003"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000678"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2018.12.013"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000159263.50305.BD"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12265-011-9273-3"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2013.04.015"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.02.021"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.09.016"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/biom9120760"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2020.09.010"},{"key":"e_1_3_2_18_2","first-page":"503","article-title":"Genetic associations with valvular calcification and aortic stenosis","volume":"29","author":"Thanassoulis G","year":"2013","unstructured":"Thanassoulis G, Campbell CY, Owens DS, Smith JG, Smith AV, Peloso GM, Kerr KF, Pechlivanis S, Budoff MJ, Harris TB, et al. Genetic associations with valvular calcification and aortic stenosis. Cardiol Rev. 2013;29:503\u2013515. doi: 10.1056\/nejmoa1109034","journal-title":"Cardiol Rev"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115184"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.R061648"},{"key":"e_1_3_2_21_2","unstructured":"New Information on Accuracy of LDL\u2010C Estimation \u2010 American College of Cardiology. Available at: https:\/\/www.acc.org\/latest\u2010in\u2010cardiology\/articles\/2020\/03\/19\/16\/00\/new\u2010information\u2010on\u2010accuracy\u2010of\u2010ldl\u2010c\u2010estimation. Accessed November 13 2021."},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90282-T"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2019.04.010"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.045120"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.007372"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2019.02.005"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.042"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2012.08.014"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12881-020-01003-3"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/4138376"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.5.1589"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2012.02.008"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2020.06.002"},{"key":"e_1_3_2_34_2","article-title":"ACC\/AHA guideline on the primary prevention of cardiovascular disease","volume":"2019","author":"Arnett DK","year":"2019","unstructured":"Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Himmelfarb CD, Khera A, Lloyd\u2010Jones D, McEvoy JW, et al. ACC\/AHA guideline on the primary prevention of cardiovascular disease. J Am Coll Cardiol. 2019;2019. doi: 10.1016\/j.jacc.2019.03.010","journal-title":"J Am Coll Cardiol"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy217"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2009.08.025"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.R051870"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.09.038"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0000000000000471"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.114.304785"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc3501.095214"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.121.024870","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:51:59Z","timestamp":1715586719000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.121.024870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,7]]},"references-count":40,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,6,7]]}},"alternative-id":["10.1161\/JAHA.121.024870"],"URL":"https:\/\/doi.org\/10.1161\/jaha.121.024870","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,7]]},"assertion":[{"value":"2021-12-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e024870"}}