Lipoprotein (a) connection to early aortic valve stenosis?

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CarolM

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Sep 15, 2012
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Cinnaminson, NJ
On 2/12/20, I had my 2nd AVR after just 7+ years. Yes, I know there are no answers "why" some valves fail far ahead of their lifespan estimates. My cardiologist and surgeon had no thoughts; sometimes it is just "luck", or genetics. That said, I personally found it dismaying to undergo this so soon, especially given a healthy diet and exercise regime.

Sooo, I did some digging on Google. There is some information on elevated lipoprotein (a) levels and early aortic valve stenosis and CV disease. My cardiologist ordered the blood test (NOT normally checked in standard cholesterol), and my level is 238! Anything over 75 is elevated.

Lp (a) is not responsive to statins, there is a strong genetic link, and currently there is no medication to lower levels. Frankly, I am not sure what will come of this information, but I certainly find it intriguing.
 

Paleowoman

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Hi @CarolM Here’s a link to an article by Dr Malcolm Kendrick in which he wrote about the role of Lp(a) in cardiovascular disease. It’s a very long article so I’ve copied just a few bits below, but to get a better understanding of what it means, the whole article is here: What causes heart disease part VI

"There has been much discussion of Lp(a) of late. What it is, what does it do, why does it matter? The first thing to point out about Lp(a) is that it is, essentially, LDL a.k.a. LDL-cholesterol a.k.a. ‘bad cholesterol.’ However, it differs in one way. It has a special strand of protein attached to it, known as apolipoprotein A.

"This protein is very interesting, from a blood clotting perspective, in that it is chemically identical to plasminogen. Yes, the one and only clot busting enzyme, switched on by tissue plasminogen activator.

"But, big but. Apolipoprotein A is folded into a slightly different structure than plasminogen. Let us say it has a right handed thread, instead of left handed thread. (This is not fully accurate, but it is close enough).

"If you incorporate Lp(a), and thus apolipoprotein A, into a blood clot, it cannot be broken down. This is because tissue plasminogen activator cannot activate it, because it is right handed. Effectively, therefore, apoliporotein A blocks the enzymatic destruction of fibrin, thus protecting the clot from destruction. Why, you may ask, would the body create such a stupid thing?

"Well, as with everything the body does, it is not stupid. It is very, very, clever. Lp(a) is only made in animals that cannot synthesize vitamin C. Guinea pigs, fruit bats, great apes and…humans. The reason for this is that, if you are vitamin C deficient, the body cannot manufacture certain important support materials/connective tissue, the most important of which is collagen.

"Without collagen, your blood vessels start to crack apart. When this happens, blood escapes, so you start bleeding from the gums, and suchlike. This condition is known as scurvy. In scurvy you start bleeding all over the place and, in the end, you die from blood loss. It is what killed many sailors of in the olden days.

"Along to the rescue comes Lp(a).. well, it can rescue you for a bit. Lp(a) sticks to cracks in blood vessel walls and forms, impossible to break up blood clots that ‘plug’ the gaps created by collagen deficiency. So you can see that Lp(a) is actually evolution’s way of protecting animals, that cannot synthesize vitamin C, from the early stages of scurvy."

"All of which means that if you don’t eat enough vitamin C, and you have a high level of Lp(a), you will end up with a multitude of very difficult to break up blood clots scattered all over your arterial walls, and inside your arterial walls too. Thus, you are going to develop CVD at a rapid rate.

"…...vitamin C deficiency is the answer to CVD? No, it is not THE answer, but it is an answer, or a part of an answer. There is no doubt that a low level vitamin C is a bad thing. There is equally no doubt that a low vitamin C level, associated with a high Lp(a) is a double bad thing. Furthermore, there is absolutely and completely no doubt that taking extra vitamin C would be a good thing for everyone – just in case."
 

CarolM

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Joined
Sep 15, 2012
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52
Location
Cinnaminson, NJ
Thank you for the link. I did read it, but frankly a lot was pretty technical for my non-medical brain. The vitamin C connection is certainly interesting though.
 

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