What does this research mean for the field?

Increased serum Lp(a) levels are associated with 38% higher odds of prevalent mitral annular calcification compared to lower levels (OR 1.38; 95% CI: 1.20, 1.59). Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This review aims to compare the occurrence of mitral annular calcification in patients with high versus normal Lp(a) levels.

February 8, 2026

Lipoprotein-(a) and mitral annular calcification: a systematic review and meta-analysis

Key Result

High lipoprotein(a) levels are associated with a 38% higher odds of mitral annular calcification (OR 1.38, 95% CI 1.20-1.59) in 20,794 individuals.

Key Points

This review aims to compare the occurrence of mitral annular calcification in patients with high versus normal Lp(a) levels.
Conducted a systematic search in databases including MEDLINE/PubMed, Web of Science, and Scopus.
Followed PRISMA guidelines for selecting relevant studies.
Performed a random effects meta-analysis on included studies.
Included a total of 3 studies with 20,794 individuals.
Pooled prevalence of mitral annular calcification was found to be 15%.
High Lp(a) levels showed a pooled odds ratio of 1.38 (95% CI: 1.20, 1.59) for prevalent MAC.

Structured PICO

Do high Lipoprotein-(a) levels increase the odds of presenting with mitral annular calcification compared to normal/low levels?

Population

20,794 individuals pooled from 3 studies, mean age 60±11 years, 43% male.

Intervention

High Lipoprotein-(a) [Lp(a)] levels

Comparator

Normal/low Lipoprotein-(a) [Lp(a)] levels

Outcome

Presence of mitral annular calcification (MAC)surrogate

High serum Lipoprotein-(a) levels are significantly associated with increased odds of mitral annular calcification, suggesting a potential shared pathophysiological pathway similar to calcific aortic stenosis.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background Lipoprotein-a Lp(a) is a well-established risk factor for atherosclerotic cardiovascular disease and calcific aortic stenosis (AS). It has been recognized that in patients with AS, increased Lp(a) is associated with faster disease progression as well as adverse events. Mitral annular calcification (MAC) has a similar to AS pathogenesis, involving pro-inflammatory and pro-osteogenic pathways; however, there are limited known predictors of its progression. Purpose In this systematic review and meta-analysis, we aimed to compare the presence of MAC in patients with high versus normal Lp(a) levels. Methods We performed a systematic search in 3 different databases (MEDLINE/PubMed, Web of Science and Scopus). After selecting all appropriate studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a random effect meta-analysis was performed. Results A total of 3 studies and 20,794 individuals were included in the meta-analysis. The pooled age of the included subjects was 60±11 years old, with 43% being male. The prevalence of MAC in the total cohort was 15%. The pooled odds ratio of high vs low Lp(a) levels for prevalent MAC was found to be 1.38 ([95%CI: 1.20, 1.59). Conclusion This systematic review and meta-analysis shows that individuals with increased serum Lp(a) have significantly higher odds of presenting with MAC. Therefore, more research is needed towards establishing genetic associations between MAC presence and specific Lp(a) gene loci, as well as providing positive links in prospective cohorts.

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