Zhang Yan, Zhu Cheng-Gang, Xu Rui-Xia, Li Sha, Guo Yuan-Lin, Sun Jing, Li Jian-Jun
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
J Clin Lipidol. 2014 Sep-Oct;8(5):494-500. doi: 10.1016/j.jacl.2014.07.001. Epub 2014 Jul 8.
Both proprotein convertase subtilisin/kexin type 9 (PCSK9) and fibrinogen have been established as novel markers for atherosclerotic diseases. However, no data are available regarding the relationship between circulating PCSK9 and fibrinogen concentration up to now.
To explore the potential link of the circulating PCSK9 concentration to fibrinogen in patients with stable coronary artery disease (CAD).
We studied 219 eligible consecutive patients with angiographically proven stable CAD. Baseline clinical and laboratory data were collected. Plasma PCSK9 concentration was measured by enzyme-linked immunosorbent assay. High-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate, D-dimer, and albumin were also measured in all subjects as inflammatory markers. The relation of the circulating PCSK9 concentration to fibrinogen was evaluated.
The data indicated that the patients with high PCSK9 concentration tended to have higher fibrinogen levels according to PCSK9 tertiles (P = .037). Spearman correlation analysis revealed a positive relation between plasma PCSK9 concentration and fibrinogen (r = 0.211, P = .002). Additionally, the circulating PCSK9 concentration also correlated positively with total cholesterol, low-density lipoprotein cholesterol, and hs-CRP levels (r = 0.333, P < .001; r = 0.302, P < .001; r = 0.153, P = .023, respectively). In the stepwise multivariate regression analysis, the association between PCSK9 and fibrinogen remained significant (β = 0.168, P = .011) after adjustment for conventional cardiovascular risk factors including lipid profiles, hs-CRP, and D-dimer.
The present study first demonstrated that the circulating PCSK9 concentration was positively associated with fibrinogen in patients with stable CAD, suggesting that the interactions of PCSK9 and fibrinogen in the status of atherosclerosis may need further investigation.
前蛋白转化酶枯草溶菌素/kexin 9型（PCSK9）和纤维蛋白原均已被确立为动脉粥样硬化性疾病的新型标志物。然而，迄今为止尚无关于循环PCSK9与纤维蛋白原浓度之间关系的数据。
探讨稳定型冠状动脉疾病（CAD）患者循环PCSK9浓度与纤维蛋白原之间的潜在联系。
我们研究了219例经血管造影证实为稳定型CAD的连续合格患者。收集基线临床和实验室数据。采用酶联免疫吸附测定法测量血浆PCSK9浓度。所有受试者还检测了高敏C反应蛋白（hs-CRP）、红细胞沉降率、D-二聚体和白蛋白作为炎症标志物。评估循环PCSK9浓度与纤维蛋白原的关系。
数据表明，根据PCSK9三分位数，PCSK9浓度高的患者往往纤维蛋白原水平更高（P = 0.037）。Spearman相关性分析显示血浆PCSK9浓度与纤维蛋白原呈正相关（r = 0.211，P = 0.002）。此外，循环PCSK9浓度还与总胆固醇、低密度脂蛋白胆固醇和hs-CRP水平呈正相关（分别为r = 0.333，P < 0.001；r = 0.302，P < 0.001；r = 0.153，P = 0.023）。在逐步多元回归分析中，在调整包括血脂谱、hs-CRP和D-二聚体在内的传统心血管危险因素后，PCSK9与纤维蛋白原之间的关联仍然显著（β = 0.168，P = 0.011）。
本研究首次表明，稳定型CAD患者循环PCSK9浓度与纤维蛋白原呈正相关，提示PCSK9与纤维蛋白原在动脉粥样硬化状态下的相互作用可能需要进一步研究。
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