Gao Y, Zhang H B, Hou L L, Wang S M
Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Oxford International Medical Research Center, Beijing 100037, China.
Zhonghua Yi Xue Za Zhi. 2019 Sep 17;99(35):2750-2755. doi: 10.3760/cma.j.issn.0376-2491.2019.35.007.
To assess whether acute-phase plasma PCSK9 levels predict recurrent cardiovascular (CV) events in acute myocardial infarction (AMI) patients without receiving reperfusion therapy. Plasma PCSK9 levels were measured during the acute phase (≤24 hours) in 882 patients who did not undergo reperfusion therapy from the China PEACE-Prospective AMI Study (2012-2014). Associations of acute-phase PCSK9 tertiles with patient characteristics and recurrent CV events at 1 year were assessed using multivariable logistic and Cox proportional hazards regression models. Female gender (odds ratio [] 2.86, 95% confidence interval [] 1.36-5.98), premature coronary heart disease (CHD) ( 2.82, 95 1.43-5.53), higher high-sensitivity C-reactive protein ( 1.69, 95 1.35-2.13), and higher triglycerides ( 1.93, 95 1.10-3.38) were associated with higher baseline PCSK9 levels. Patients with PCSK9 levels in the highest tertile (versus lowest) did not have an increased risk of 1-year recurrent CV events ( 0.77, 95 0.44-1.34). Acute-phase plasma PCSK9 levels are associated with levels of inflammation and triglycerides, premature CHD, and gender in AMI patients without reperfusion therapy, however it do not predict recurrent CV events at 1 year.
为评估急性期血浆前蛋白转化酶枯草溶菌素9（PCSK9）水平能否预测未接受再灌注治疗的急性心肌梗死（AMI）患者复发性心血管（CV）事件。在中国急性心肌梗死前瞻性研究（2012 - 2014年）中，对882例未接受再灌注治疗的患者在急性期（≤24小时）测量血浆PCSK9水平。使用多变量逻辑回归和Cox比例风险回归模型评估急性期PCSK9三分位数与患者特征及1年时复发性CV事件的关联。女性（比值比[ ]2.86，95%置信区间[ ]1.36 - 5.98）、早发冠心病（CHD）（[ ]2.82，95%[ ]1.43 - 5.53）、较高的高敏C反应蛋白（[ ]1.69，95%[ ]1.35 - 2.13）和较高的甘油三酯（[ ]1.93，95%[ ]1.10 - 3.38）与较高的基线PCSK9水平相关。PCSK9水平处于最高三分位数的患者（与最低三分位数相比）1年复发性CV事件风险未增加（[ ]0.77，95%[ ]0.44 - 1.34）。在未接受再灌注治疗的AMI患者中，急性期血浆PCSK9水平与炎症、甘油三酯水平、早发CHD及性别相关，但不能预测1年时的复发性CV事件。
