Diabetes Metab J.  2018 Jun;42(3):207-214. 10.4093/dmj.2017.0081.

Serum Levels of PCSK9 Are Associated with Coronary Angiographic Severity in Patients with Acute Coronary Syndrome

• Bae KH
• Kim SW
• Choi YK
• Seo JB
• Kim N
• Kim CY
• Lee WK
• Lee S
• Kim JG
• Lee IK
• Lee JH
• Park KG

• KMID: 2413983
• DOI: http://doi.org/10.4093/dmj.2017.0081

Abstract

BACKGROUND
Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a circulating protein that promotes degradation of the low density lipoprotein receptor. PCSK9 has emerged as a target for lipid-lowering therapy, but the predictive value of the serum level of PCSK9 for the severity of coronary disease is largely unknown.
METHODS
From December 2009 to July 2012, 121 individuals who underwent coronary angiography (CAG) because of clinically suspected acute coronary syndrome were enrolled in this study. Serum levels of PCSK9 and metabolic parameters were measured. SYNTAX (SYNergy between percutaneous coronary intervention with [paclitaxel-eluting] TAXUS stent and cardiac surgery) and GRACE (Global Registry of Acute Coronary Events) scores were calculated.
RESULTS
Individuals with CAG lesions (n=100) had significantly higher levels of PCSK9 than those without lesions (n=21). The study population was stratified into three groups according to serum levels of PCSK9. The odds radio for occurrence of one or more CAG lesions was significantly higher in the group with the highest level of PCSK9 (odds ratio, 7.468; P=0.011) than in the group with the lowest level of PCSK9. Serum PCSK9 was positively associated with the number of involved coronary arteries. Multivariable linear regression indicated that levels of PCSK9 were positively correlated with GRACE risk scores and SYNTAX scores.
CONCLUSION
Serum PCSK9 concentrations are higher in patients with coronary artery lesions, and are associated with SYNTAX and GRACE scores, suggesting that PCSK9 is a potential biomarker of the severity of coronary artery disease.

Keyword

Cardiovascular diseases; Coronary angiography; Proprotein convertase 9

MeSH Terms

Acute Coronary Syndrome*
Cardiovascular Diseases
Coronary Angiography
Coronary Artery Disease
Coronary Disease
Coronary Vessels
Humans
Linear Models
Percutaneous Coronary Intervention
Proprotein Convertases
Receptors, LDL
Stents
Taxus
Proprotein Convertases
Receptors, LDL

Figure

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  Fig. 1 Associations between serum proprotein convertase subtilisin/kexin type 9 (PCSK9) concentrations and numbers of involved arteries identified by coronary angiography. NS, not significant. aP<0.05.

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