Nose Daisuke, Shiga Yuhei, Ueda Yoko, Idemoto Yoshiaki, Tashiro Kohei, Suematsu Yasusnori, Kuwano Takashi, Kitajima Ken, Saku Keijiro, Miura Shin-Ichiro
Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka, Japan.
Heart Vessels. 2019 Jan;34(1):19-28. doi: 10.1007/s00380-018-1218-1. Epub 2018 Jul 5.
The ability of pro-protein convertase subtilisin/kexin type 9 (PCSK9) levels to predict the presence or severity of coronary artery disease (CAD) remains controversial. The purpose of this study was to investigate these associations. We enrolled 393 patients who were clinically suspected to have CAD or who had at least one cardiac risk factor and underwent multidetector-row computed tomography coronary angiography. The presence of CAD (≥50% coronary stenosis), the number of significantly stenosed coronary vessels, and plasma levels of PCSK9 by ELISA were analyzed. Plasma PCSK9 levels (log-transformed data) were significantly associated with the presence of CAD. Next, we divided the patients into two groups (non-statin and statin groups) according to statin treatment. PCSK9 levels in the non-statin group were significantly lower than those in the statin group. There were no significant differences in PCSK9 levels between the absence and presence of CAD in the statin group. However, in the non-statin group, PCSK9 levels in patients with CAD were significantly higher than those in patients without CAD. PCSK9 levels, in addition to age, gender, BMI, DM and HDL-C, were independently associated with the presence of CAD by a multivariable analysis. In conclusion, our results demonstrated that plasma PCSK9 levels may be a marker for evaluating the presence of CAD.
前蛋白转化酶枯草溶菌素/克新9型（PCSK9）水平预测冠状动脉疾病（CAD）的存在或严重程度的能力仍存在争议。本研究的目的是调查这些关联。我们纳入了393例临床怀疑患有CAD或至少有一个心脏危险因素并接受多排螺旋计算机断层扫描冠状动脉造影的患者。分析了CAD（冠状动脉狭窄≥50%）的存在、冠状动脉显著狭窄血管的数量以及通过酶联免疫吸附测定法检测的血浆PCSK9水平。血浆PCSK9水平（对数转换数据）与CAD的存在显著相关。接下来，我们根据他汀类药物治疗将患者分为两组（非他汀类药物组和他汀类药物组）。非他汀类药物组的PCSK9水平显著低于他汀类药物组。他汀类药物组中CAD存在与否的PCSK9水平无显著差异。然而，在非他汀类药物组中，CAD患者的PCSK9水平显著高于无CAD患者。通过多变量分析，除年龄、性别、体重指数、糖尿病和高密度脂蛋白胆固醇外，PCSK9水平与CAD的存在独立相关。总之，我们的结果表明，血浆PCSK9水平可能是评估CAD存在的一个标志物。
