Association of rotating night shift work with tooth loss and severe periodontitis among permanent employees in Japan: a cross-sectional study.

INTRODUCTION

Severe aortic stenosis (AS) can be treated with transcatheter aortic valve implantation (TAVI). There is emerging evidence suggesting that high lipoprotein(a) (Lp[a]) levels may be associated with worse outcomes after TAVI.

OBJECTIVES

We aimed to compare major adverse cardiac and cerebrovascular events (MACCEs) within 12 months after TAVI and long‑term survival in patients with high and low Lp(a) levels.

PATIENTS AND

METHODS

In this prospective, multicenter cohort study we included patients with severe AS qualified for TAVI with stored plasma available for Lp(a) measurement. The patients were stratified into high- and low‑Lp(a) groups (cutoff, 30 mg/dl). Two primary end points were 12‑month MACCE and long‑term overall survival. Secondary end points were individual components of MACCE.

RESULTS

Between November 2018 and September 2021, TAVI was performed across 3 clinical sites; stored plasma was available for Lp(a) level measurement in 82 patients. We observed no difference in MACCE occurrence in the high- and low‑Lp(a) groups. In unadjusted analyses, the patients with elevated Lp(a) levels had worse long‑term survival during median follow‑up of 2.8 years (log‑rank P = 0.045) but this difference lost significance after adjustments for age and sex in a Cox regression model (hazard ratio, 2.85; 95% CI, 0.85-9.55; P = 0.054). None of the secondary end points differed significantly between the groups.

CONCLUSIONS

The patients with elevated Lp(a) level had a comparable risk of 12‑month MACCE after TAVI to those with low Lp(a) level but might have worse long‑term survival. Long‑term findings should be considered exploratory and require further confirmation.