{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:59:09Z","timestamp":1791914349035,"version":"4.3.4"},"reference-count":116,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T00:00:00Z","timestamp":1696550400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>To date, no medical therapy can slow the progression of aortic stenosis. Fibrocalcific stenosis is the most frequent form in the general population and affects about 6% of the elderly population. Over the years, diagnosis has evolved thanks to echocardiography and computed tomography assessments. The application of artificial intelligence to electrocardiography could further implement early diagnosis. Patients with severe aortic stenosis, especially symptomatic patients, have valve repair as their only therapeutic option by surgical or percutaneous technique (TAVI). The discovery that the pathogenetic mechanism of aortic stenosis is similar to the atherosclerosis process has made it possible to evaluate the hypothesis of medical therapy for aortic stenosis. Several drugs have been tested to reduce low-density lipoprotein (LDL) and lipoprotein(a) (Lp(a)) levels, inflammation, and calcification. The Proprotein Convertase Subtilisin\/Kexin type 9 inhibitors (PCSK9-i) could decrease the progression of aortic stenosis and the requirement for valve implantation. Great interest is related to circulating Lp(a) levels as causally linked to degenerative aortic stenosis. New therapies with ASO (antisense oligonucleotides) and siRNA (small interfering RNA) are currently being tested. Olpasiran and pelacarsen reduce circulating Lp(a) levels by 85\u201390%. Phase 3 studies are underway to evaluate the effect of these drugs on cardiovascular events (cardiovascular death, non-fatal myocardial injury, and non-fatal stroke) in patients with elevated Lp(a) and CVD (cardiovascular diseases). For instance, if a reduction in Lp(a) levels is associated with aortic stenosis prevention or progression, further prospective clinical trials are warranted to confirm this observation in this high-risk population.<\/jats:p>","DOI":"10.3390\/ijms241914939","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T01:07:13Z","timestamp":1696554433000},"page":"14939","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Lp(a) in the Pathogenesis of Aortic Stenosis and Approach to Therapy with Antisense Oligonucleotides or Short Interfering RNA"],"prefix":"10.3390","volume":"24","author":[{"given":"Assunta","family":"Di Costanzo","sequence":"first","affiliation":[{"name":"Division of Cardiology, Cardiovascular Research Center, University Magna Graecia Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1241-6487","authenticated-orcid":false,"given":"Ciro","family":"Indolfi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiovascular Research Center, University Magna Graecia Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Franzone","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Esposito","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1825-0510","authenticated-orcid":false,"given":"Carmen Anna Maria","family":"Spaccarotella","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16006","DOI":"10.1038\/nrdp.2016.6","article-title":"Calcific aortic stenosis","volume":"2","author":"Lindman","year":"2016","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.1161\/ATVBAHA.114.302523","article-title":"Calcific Aortic Valve Disease: A Consensus Summary from the Alliance of Investigators on Calcific Aortic Valve Disease","volume":"34","author":"Yutzey","year":"2014","journal-title":"ATVB"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1056\/NEJMra1313875","article-title":"Aortic-Valve Stenosis\u2014From Patients at Risk to Severe Valve Obstruction","volume":"371","author":"Otto","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"V-61","DOI":"10.1161\/01.CIR.38.1S5.V-61","article-title":"Aortic Stenosis","volume":"38","author":"Ross","year":"1968","journal-title":"Circulation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1161\/CIRCRESAHA.110.234146","article-title":"Molecular Imaging Insights into Early Inflammatory Stages of Arterial and Aortic Valve Calcification","volume":"108","author":"New","year":"2011","journal-title":"Circ. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1097\/MOL.0b013e3282a66099","article-title":"Aortic valve stenosis: An active atheroinflammatory process","volume":"18","author":"Helske","year":"2007","journal-title":"Curr. Opin. Lipidol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jchf.2015.09.015","article-title":"Assessing the Risk of Progression from Asymptomatic Left Ventricular Dysfunction to Overt Heart Failure","volume":"4","author":"Erqou","year":"2016","journal-title":"JACC Heart Fail."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s00392-019-01539-2","article-title":"Expert consensus document on the assessment of the severity of aortic valve stenosis by echocardiography to provide diagnostic conclusiveness by standardized verifiable documentation","volume":"109","author":"Hagendorff","year":"2020","journal-title":"Clin. Res. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4717","DOI":"10.1093\/eurheartj\/ehab649","article-title":"Application of artificial intelligence to the electrocardiogram","volume":"42","author":"Attia","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_11","first-page":"e72","article-title":"2020 ACC\/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Auffret, V., Ridard, C., Salerno, N., and Sorrentino, S. (2022). Unmet Needs in TAVR: Conduction Disturbances and Management of Coronary Artery Disease. JCM, 11.","DOI":"10.3390\/jcm11216256"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.ijcard.2019.05.056","article-title":"Which hospital should be selected for readmission after TAVR?","volume":"293","author":"Spaccarotella","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1098\/rstb.2007.2125","article-title":"Heart valve macro- and microstructure","volume":"362","author":"Misfeld","year":"2007","journal-title":"Phil. Trans. R. Soc. B"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1098\/rstb.2007.2130","article-title":"Valvulogenesis: The moving target","volume":"362","author":"Butcher","year":"2007","journal-title":"Phil. Trans. R. Soc. B"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e006339","DOI":"10.1161\/JAHA.117.006339","article-title":"Valve Interstitial Cells: The Key to Understanding the Pathophysiology of Heart Valve Calcification","volume":"6","author":"Rutkovskiy","year":"2017","journal-title":"JAHA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.jacc.2015.05.066","article-title":"Calcification in Aortic Stenosis","volume":"66","author":"Pawade","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1136\/heart.85.6.635","article-title":"The vitamin D receptor genotype predisposes to the development of calcific aortic valve stenosis","volume":"85","author":"Ortlepp","year":"2001","journal-title":"Heart"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1046\/j.1365-2796.2003.01179.x","article-title":"Oestrogen receptor alpha gene polymorphism is related to aortic valve sclerosis in postmenopausal women","volume":"254","author":"Nordstrom","year":"2003","journal-title":"J. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1804","DOI":"10.1161\/01.CIR.0000097560.96431.3E","article-title":"Association Between Apolipoprotein E Alleles and Calcific Valvular Heart Disease","volume":"108","author":"Novaro","year":"2003","journal-title":"Circulation"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.ehj.2003.09.006","article-title":"The amount of calcium-deficient hexagonal hydroxyapatite in aortic valves is influenced by gender and associated with genetic polymorphisms in patients with severe calcific aortic stenosis","volume":"25","author":"Ortlepp","year":"2004","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.1093\/eurheartj\/ehad142","article-title":"Dyslipidemia, inflammation, calcification, and adiposity in aortic stenosis: A genome-wide study","volume":"44","author":"Dina","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1161\/CIRCULATIONAHA.122.061451","article-title":"Multiancestry Genome-Wide Association Study of Aortic Stenosis Identifies Multiple Novel Loci in the Million Veteran Program","volume":"147","author":"Small","year":"2023","journal-title":"Circulation"},{"key":"ref_24","first-page":"941","article-title":"Aortic valve disease in the older adult","volume":"13","author":"Bhatia","year":"2016","journal-title":"J. Geriatr. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Kr\u00fcger-Genge, A., Blocki, A., Franke, R.-P., and Jung, F. (2019). Vascular Endothelial Cell Biology: An Update. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20184411"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1161\/CIRCRESAHA.112.300154","article-title":"Hemodynamic and cellular response feedback in calcific aortic valve disease","volume":"113","author":"Gould","year":"2013","journal-title":"Circ. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1056\/NEJMoa1109034","article-title":"Genetic Associations with Valvular Calcification and Aortic Stenosis","volume":"368","author":"Thanassoulis","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2690","DOI":"10.1210\/jc.2015-1096","article-title":"Elevated Lipoprotein(a) Does Not Cause Low-Grade Inflammation Despite Causal Association With Aortic Valve Stenosis and Myocardial Infarction: A Study of 100,578 Individuals from the General Population","volume":"100","author":"Langsted","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1161\/CIRCGENETICS.113.000400","article-title":"Lipoprotein(a) levels, genotype, and incident aortic valve stenosis: A prospective Mendelian randomization study and replication in a case-control cohort","volume":"7","author":"Arsenault","year":"2014","journal-title":"Circ. Cardiovasc. Genet."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1161\/01.ATV.16.4.523","article-title":"Apolipoproteins B, (a), and E accumulate in the morphologically early lesion of \u201cdegenerative\u201d valvular aortic stenosis","volume":"16","author":"Reichenbach","year":"1996","journal-title":"Arter. Thromb. Vasc. Biol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.1016\/j.ajpath.2013.01.037","article-title":"Side-Specific Endothelial-Dependent Regulation of Aortic Valve Calcification","volume":"182","author":"Richards","year":"2013","journal-title":"Am. J. Pathol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1016\/j.jacc.2015.07.020","article-title":"Oxidized Phospholipids, Lipoprotein(a), and Progression of Calcific Aortic Valve Stenosis","volume":"66","author":"Capoulade","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.jacc.2013.05.105","article-title":"Elevated Expression of Lipoprotein-Associated Phospholipase A2 in Calcific Aortic Valve Disease","volume":"63","author":"Mahmut","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1097\/01.mol.0000174155.61307.5f","article-title":"Lipoprotein-associated phospholipase A2 as a target of therapy","volume":"16","author":"Macphee","year":"2005","journal-title":"Curr. Opin. Lipidol."},{"key":"ref_35","first-page":"1825","article-title":"Lipoprotein-associated phospholipase A2 is elevated in patients with severe aortic valve stenosis without clinically overt atherosclerosis","volume":"50","author":"Fil","year":"2012","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1016\/j.jacbts.2020.06.012","article-title":"Interaction of Autotaxin With Lipoprotein(a) in Patients With Calcific Aortic Valve Stenosis","volume":"5","author":"Bourgeois","year":"2020","journal-title":"JACC Basic Transl. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.jss.2017.02.028","article-title":"Lysophosphatidylcholine activates the Akt pathway to upregulate extracellular matrix protein production in human aortic valve cells","volume":"213","author":"Cheng","year":"2017","journal-title":"J. Surg. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1586\/erc.11.72","article-title":"Role of 5-lipoxygenase pathway in the pathophysiology of the aortic stenosis","volume":"9","author":"Akdemir","year":"2011","journal-title":"Expert Rev. Cardiovasc. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1161\/ATVBAHA.114.305159","article-title":"COX2 inhibition reduces aortic valve calcification in vivo","volume":"35","author":"Wirrig","year":"2015","journal-title":"Arter. Thromb. Vasc. Biol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Vieceli Dalla Sega, F., Fortini, F., Cimaglia, P., Marracino, L., Tonet, E., Antonucci, A., Moscarelli, M., Campo, G., Rizzo, P., and Ferrari, R. (2020). COX-2 Is Downregulated in Human Stenotic Aortic Valves and Its Inhibition Promotes Dystrophic Calcification. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21238917"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.atherosclerosis.2010.04.005","article-title":"Lyso-phosphatidylcholine induces osteogenic gene expression and phenotype in vascular smooth muscle cells","volume":"211","author":"Vickers","year":"2010","journal-title":"Atherosclerosis"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Schnitzler, J.G., Ali, L., Groenen, A.G., Kaiser, Y., and Kroon, J. (2019). Lipoprotein(a) as Orchestrator of Calcific Aortic Valve Stenosis. Biomolecules, 9.","DOI":"10.3390\/biom9120760"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"C29","DOI":"10.1152\/ajpcell.00137.2007","article-title":"Expression of functional Toll-like receptors 2 and 4 in human aortic valve interstitial cells: Potential roles in aortic valve inflammation and stenosis","volume":"294","author":"Meng","year":"2008","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Zeng, Q., Song, R., Ao, L., Xu, D., Venardos, N., Fullerton, D.A., and Meng, X. (2014). Augmented osteogenic responses in human aortic valve cells exposed to oxLDL and TLR4 agonist: A mechanistic role of Notch1 and NF-\u03baB interaction. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0095400"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1093\/eurheartj\/eht034","article-title":"Aortic stenosis, atherosclerosis, and skeletal bone: Is there a common link with calcification and inflammation?","volume":"34","author":"Dweck","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.atherosclerosis.2018.08.029","article-title":"Inflammatory and metabolic mechanisms underlying the calcific aortic valve disease","volume":"277","author":"Cho","year":"2018","journal-title":"Atherosclerosis"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s10753-012-9579-6","article-title":"Inflammation is associated with the remodeling of calcific aortic valve disease","volume":"36","author":"Mahmut","year":"2013","journal-title":"Inflammation"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"4","DOI":"10.18087\/cardio.n328","article-title":"The renin-angiotensin-aldosterone system as a potential target for therapy in patients with calcific aortic stenosis: A literature review","volume":"59","author":"Kostyunin","year":"2019","journal-title":"Kardiologiia"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1161\/01.CIR.0000035655.45453.D2","article-title":"Association of angiotensin-converting enzyme with low-density lipoprotein in aortic valvular lesions and in human plasma","volume":"106","author":"Shavelle","year":"2002","journal-title":"Circulation"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1016\/j.jacc.2006.11.043","article-title":"Angiotensin receptor-1 blocker inhibits atherosclerotic changes and endothelial disruption of the aortic valve in hypercholesterolemic rabbits","volume":"49","author":"Arishiro","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.jacc.2011.01.063","article-title":"Impact of renin-angiotensin system blockade therapy on outcome in aortic stenosis","volume":"58","author":"Nadir","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"198","DOI":"10.3109\/01913123.2014.991884","article-title":"HIF-1\u03b1 and VEGF: Immunohistochemical Profile and Possible Function in Human Aortic Valve Stenosis","volume":"39","author":"Perrotta","year":"2015","journal-title":"Ultrastruct. Pathol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"115542","DOI":"10.1016\/j.bone.2020.115542","article-title":"The role of bone morphogenetic protein signaling in vascular calcification","volume":"141","author":"Yang","year":"2020","journal-title":"Bone"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Klauzen, P., Semenova, D., Kostina, D., Uspenskiy, V., and Malashicheva, A. (2023). Purinergic Signaling in Pathologic Osteogenic Differentiation of Aortic Valve Interstitial Cells from Patients with Aortic Valve Calcification. Biomedicines, 11.","DOI":"10.3390\/biomedicines11020307"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.yjmcc.2015.03.002","article-title":"Carbonic anhydrase XII in valve interstitial cells promotes the regression of calcific aortic valve stenosis","volume":"82","author":"Bouchareb","year":"2015","journal-title":"J. Mol. Cell. Cardiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"H856","DOI":"10.1152\/ajpheart.00117.2011","article-title":"Discovery of shear- and side-specific mRNAs and miRNAs in human aortic valvular endothelial cells","volume":"301","author":"Holliday","year":"2011","journal-title":"Am. J. Physiol.-Heart Circ. Physiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"25397","DOI":"10.1038\/srep25397","article-title":"Identification of side- and shear-dependent microRNAs regulating porcine aortic valve pathogenesis","volume":"6","author":"Rathan","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"145987","DOI":"10.1016\/j.gene.2021.145987","article-title":"Exploring potential genes and pathways related to calcific aortic valve disease","volume":"808","author":"Qiao","year":"2022","journal-title":"Gene"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.cell.2015.02.035","article-title":"Human Disease Modeling Reveals Integrated Transcriptional and Epigenetic Mechanisms of NOTCH1 Haploinsufficiency","volume":"160","author":"Theodoris","year":"2015","journal-title":"Cell"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.1093\/eurheartj\/ehr259","article-title":"EAE\/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease","volume":"32","author":"Zamorano","year":"2011","journal-title":"Eur. Heart J."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2008.11.029","article-title":"Echocardiographic Assessment of Valve Stenosis: EAE\/ASE Recommendations for Clinical Practice","volume":"22","author":"Baumgartner","year":"2009","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"De Rosa, S., Sabatino, J., Strangio, A., Leo, I., Romano, L.R., Spaccarotella, C.A., Mongiardo, A., Polimeni, A., Sorrentino, S., and Indolfi, C. (2022). Non-Invasive Myocardial Work in Patients with Severe Aortic Stenosis. J. Clin. Med., 11.","DOI":"10.3390\/jcm11030747"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.echo.2022.10.011","article-title":"Prognostic Value of Left Atrial Strain in Aortic Stenosis: A Competing Risk Analysis","volume":"36","author":"Tan","year":"2023","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/j.mayocp.2022.04.004","article-title":"Progression of Calcific Aortic Stenosis Detected by Artificial Intelligence Electrocardiogram","volume":"97","author":"Harmon","year":"2022","journal-title":"Mayo Clin. Proc."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2885","DOI":"10.1093\/eurheartj\/ehab153","article-title":"Electrocardiogram screening for aortic valve stenosis using artificial intelligence","volume":"42","author":"Attia","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"3290","DOI":"10.1161\/CIRCULATIONAHA.104.495903","article-title":"Outcome of 622 adults with asymptomatic, hemodynamically significant aortic stenosis during prolonged follow-up","volume":"111","author":"Pellikka","year":"2005","journal-title":"Circulation"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1056\/NEJMoa1912846","article-title":"Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis","volume":"382","author":"Kang","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1055\/a-1999-7271","article-title":"Myocardial Evaluation in Patients with Aortic Stenosis by Cardiac Computed Tomography","volume":"195","author":"Gama","year":"2023","journal-title":"Rofo"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.ijcard.2017.04.107","article-title":"Transcatheter aortic valve implantation in patients at intermediate surgical risk","volume":"243","author":"Spaccarotella","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Sorrentino, S., Nguyen, P., Salerno, N., Polimeni, A., Sabatino, J., Makris, A., Hennessy, A., Giustino, G., Spaccarotella, C., and Mongiardo, A. (2020). Standard Versus Ultrasound-Guided Cannulation of the Femoral Artery in Patients Undergoing Invasive Procedures: A Meta-Analysis of Randomized Controlled Trials. J. Clin. Med., 9.","DOI":"10.3390\/jcm9030677"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","article-title":"Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients","volume":"380","author":"Popma","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","article-title":"Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients","volume":"380","author":"Mack","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Polimeni, A., Sorrentino, S., De Rosa, S., Spaccarotella, C., Mongiardo, A., Sabatino, J., and Indolfi, C. (2020). Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients for the Treatment of Severe Aortic Stenosis. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020439"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1016\/j.jcin.2021.03.024","article-title":"Development and Validation of a Practical Model to Identify Patients at Risk of Bleeding after TAVR","volume":"14","author":"Navarese","year":"2021","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1161\/CIRCULATIONAHA.121.054305","article-title":"Antithrombotic Therapy in Patients Undergoing Transcatheter Interventions for Structural Heart Disease","volume":"144","author":"Gragnano","year":"2021","journal-title":"Circulation"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"E908","DOI":"10.1002\/ccd.29807","article-title":"Incidence, predictors and clinical impact of permanent pacemaker insertion in women following transcatheter aortic valve implantation: Insights from a prospective multinational registry","volume":"98","author":"Nicolas","year":"2021","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1016\/j.jacc.2010.05.050","article-title":"Bisphosphonate Use and Prevalence of Valvular and Vascular Calcification in Women","volume":"56","author":"Elmariah","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1016\/j.jacc.2012.01.024","article-title":"Do Bisphosphonates Slow the Progression of Aortic Stenosis?","volume":"59","author":"Aksoy","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1159\/000321418","article-title":"Bisphosphonates in Calcific Aortic Stenosis: Association with Slower Progression in Mild Disease\u2014A Pilot Retrospective Study","volume":"117","author":"Sterbakova","year":"2010","journal-title":"Cardiology"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"473","DOI":"10.2353\/ajpath.2009.080957","article-title":"Inhibition of Receptor Activator of NF-\u03baB Ligand by Denosumab Attenuates Vascular Calcium Deposition in Mice","volume":"175","author":"Helas","year":"2009","journal-title":"Am. J. Pathol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"2418","DOI":"10.1161\/CIRCULATIONAHA.121.053708","article-title":"Effect of Denosumab or Alendronic Acid on the Progression of Aortic Stenosis: A Double-Blind Randomized Controlled Trial","volume":"143","author":"Pawade","year":"2021","journal-title":"Circulation"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1093\/ndt\/gfq725","article-title":"The ADVANCE study: A randomized study to evaluate the effects of cinacalcet plus low-dose vitamin D on vascular calcification in patients on hemodialysis","volume":"26","author":"Raggi","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1053\/j.ackd.2019.10.004","article-title":"Valvular Calcification in Chronic Kidney Disease","volume":"26","author":"Brandenburg","year":"2019","journal-title":"Adv. Chronic Kidney Dis."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.amjcard.2005.05.014","article-title":"Relation of oral anticoagulation to cardiac valvular and coronary calcium assessed by multislice spiral computed tomography","volume":"96","author":"Koos","year":"2005","journal-title":"Am. J. Cardiol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1093\/ckj\/sfv146","article-title":"The effects of vitamin K supplementation and vitamin K antagonists on progression of vascular calcification: Ongoing randomized controlled trials","volume":"9","author":"Pyfferoen","year":"2016","journal-title":"Clin. Kidney J."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ejphar.2016.05.022","article-title":"Vitamin K2 regression aortic calcification induced by warfarin via Gas6\/Axl survival pathway in rats","volume":"786","author":"Jiang","year":"2016","journal-title":"Eur. J. Pharmacol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"2069","DOI":"10.1038\/s41598-018-20241-3","article-title":"Magnesium prevents vascular calcification in vitro by inhibition of hydroxyapatite crystal formation","volume":"8","author":"Tinnemans","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1186\/s13063-022-06562-9","article-title":"Reversal Of Arterial Disease by modulating Magnesium and Phosphate (ROADMAP-study): Rationale and design of a randomized controlled trial assessing the effects of magnesium citrate supplementation and phosphate-binding therapy on arterial stiffness in moderate chronic kidney disease","volume":"23","author":"Vermeulen","year":"2022","journal-title":"Trials"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"3925","DOI":"10.1093\/eurheartj\/ehac361","article-title":"Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: A European Atherosclerosis Society consensus statement","volume":"43","author":"Kronenberg","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"2844","DOI":"10.1093\/eurheartj\/ehq386","article-title":"Lipoprotein(a) as a cardiovascular risk factor: Current status","volume":"31","author":"Nordestgaard","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1001\/jamacardio.2020.0728","article-title":"An Exploratory Analysis of Proprotein Convertase Subtilisin\/Kexin Type 9 Inhibition and Aortic Stenosis in the FOURIER Trial","volume":"5","author":"Bergmark","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s11883-019-0773-y","article-title":"Can Lp(a) Lowering Against Background Statin Therapy Really Reduce Cardiovascular Risk?","volume":"21","author":"Reiner","year":"2019","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Gareri, C., Polimeni, A., Giordano, S., Tamm\u00e8, L., Curcio, A., and Indolfi, C. (2022). Antisense Oligonucleotides and Small Interfering RNA for the Treatment of Dyslipidemias. JCM, 11.","DOI":"10.3390\/jcm11133884"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.jacl.2016.01.005","article-title":"Effect of therapeutic interventions on oxidized phospholipids on apolipoprotein B100 and lipoprotein(a)","volume":"10","author":"Yeang","year":"2016","journal-title":"J. Clin. Lipidol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/j.jacbts.2020.05.004","article-title":"Genetic and In Vitro Inhibition of PCSK9 and Calcific Aortic Valve Stenosis","volume":"5","author":"Perrot","year":"2020","journal-title":"JACC Basic Transl. Sci."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1016\/j.metabol.2016.08.007","article-title":"Effect of extended-release niacin on plasma lipoprotein(a) levels: A systematic review and meta-analysis of randomized placebo-controlled trials","volume":"65","author":"Sahebkar","year":"2016","journal-title":"Metabolism"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1161\/ATVBAHA.117.309549","article-title":"CETP (Cholesteryl Ester Transfer Protein) Inhibition with Anacetrapib Decreases Production of Lipoprotein(a) in Mildly Hypercholesterolemic Subjects","volume":"37","author":"Thomas","year":"2017","journal-title":"Arter. Thromb. Vasc. Biol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1194\/jlr.P082834","article-title":"Effects of mipomersen, an apolipoprotein B100 antisense, on lipoprotein (a) metabolism in healthy subjects","volume":"59","author":"Nandakumar","year":"2018","journal-title":"J. Lipid Res."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1007\/s40265-019-01114-z","article-title":"Efficacy and Safety of Mipomersen: A Systematic Review and Meta-Analysis of Randomized Clinical Trials","volume":"79","author":"Fogacci","year":"2019","journal-title":"Drugs"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/j.jacc.2021.12.032","article-title":"Effect of Pelacarsen on Lipoprotein(a) Cholesterol and Corrected Low-Density Lipoprotein Cholesterol","volume":"79","author":"Yeang","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1001\/jama.2022.5050","article-title":"Single Ascending Dose Study of a Short Interfering RNA Targeting Lipoprotein(a) Production in Individuals with Elevated Plasma Lipoprotein(a) Levels","volume":"327","author":"Nissen","year":"2022","journal-title":"JAMA"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"2389","DOI":"10.1056\/NEJMoa043876","article-title":"A Randomized Trial of Intensive Lipid-Lowering Therapy in Calcific Aortic Stenosis","volume":"352","author":"Cowell","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1056\/NEJMoa0804602","article-title":"Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis","volume":"359","author":"Pedersen","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1161\/CIRCULATIONAHA.109.900027","article-title":"ASTRONOMER Investigators Effect of Lipid lowering with rosuvastatin on progression of aortic stenosis: Results of the aortic stenosis progression observation: Measuring effects of rosuvastatin (ASTRONOMER) trial","volume":"121","author":"Chan","year":"2010","journal-title":"Circulation"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"3281","DOI":"10.1210\/jc.2016-1206","article-title":"PCSK9 R46L Loss-of-Function Mutation Reduces Lipoprotein(a), LDL Cholesterol, and Risk of Aortic Valve Stenosis","volume":"101","author":"Langsted","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.jacl.2015.11.014","article-title":"Evacetrapib alone or in combination with statins lowers lipoprotein(a) and total and small LDL particle concentrations in mildly hypercholesterolemic patients","volume":"10","author":"Nicholls","year":"2016","journal-title":"J. Clin. Lipidol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1001\/jama.283.14.1845","article-title":"Estrogen and progestin, lipoprotein(a), and the risk of recurrent coronary heart disease events after menopause","volume":"283","author":"Shlipak","year":"2000","journal-title":"JAMA"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"828","DOI":"10.2337\/dc10-1233","article-title":"Testosterone replacement in hypogonadal men with type 2 diabetes and\/or metabolic syndrome (the TIMES2 study)","volume":"34","author":"Jones","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1124\/dmd.121.000418","article-title":"Adverse Drug Reactions and Toxicity of the Food and Drug Administration\u2013Approved Antisense Oligonucleotide Drugs","volume":"50","author":"Alhamadani","year":"2022","journal-title":"Drug Metab. Dispos."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1016\/S0140-6736(16)31009-1","article-title":"Antisense oligonucleotides targeting apolipoprotein(a) in people with raised lipoprotein(a): Two randomised, double-blind, placebo-controlled, dose-ranging trials","volume":"388","author":"Viney","year":"2016","journal-title":"Lancet"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1016\/S0140-6736(15)61252-1","article-title":"Antisense therapy targeting apolipoprotein(a): A randomised, double-blind, placebo-controlled phase 1 study","volume":"386","author":"Tsimikas","year":"2015","journal-title":"Lancet"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1097\/FJC.0000000000001045","article-title":"The Role of Antisense Therapies Targeting Lipoprotein(a)","volume":"78","author":"Plakogiannis","year":"2021","journal-title":"J. Cardiovasc. Pharmacol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1016\/j.clinthera.2022.07.008","article-title":"Pharmacokinetics, Pharmacodynamics, and Tolerability of Olpasiran in Healthy Japanese and Non-Japanese Participants: Results from a Phase I, Single-Dose, Open-Label Study","volume":"44","author":"Sohn","year":"2022","journal-title":"Clin. Ther."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1038\/s41591-021-01634-w","article-title":"Preclinical development and phase 1 trial of a novel siRNA targeting lipoprotein(a)","volume":"28","author":"Koren","year":"2022","journal-title":"Nat. Med."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1056\/NEJMoa2211023","article-title":"Small Interfering RNA to Reduce Lipoprotein(a) in Cardiovascular Disease","volume":"387","author":"Rosenson","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.ahj.2022.05.004","article-title":"Study design and rationale for the Olpasiran trials of Cardiovascular Events And lipoproteiN(a) reduction-DOSE finding study (OCEAN(a)-DOSE)","volume":"251","author":"Knusel","year":"2022","journal-title":"Am. Heart J."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/19\/14939\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:01:50Z","timestamp":1760130110000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/19\/14939"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,6]]},"references-count":116,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["ijms241914939"],"URL":"https:\/\/doi.org\/10.3390\/ijms241914939","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,6]]}}}