Chest Hospital, Tianjin University, No.92 Weijin Road Nankai District, Tianjin, 300072, P.R. China.
Thoracic Clinical College, Tianjin Medical University, No.22 Qi xiang tai Road, Heping District, Tianjin, 300070, P.R. China.
Lipids Health Dis. 2021 May 27;20(1):56. doi: 10.1186/s12944-021-01478-w.
Proprotein convertase subtilisin/kexin type 9 (Pcsk9) correlated with incidence and prognosis of coronary heart disease. However, it is unclear whether Pcsk9 contributed to coronary artery lesion severity in patients with premature myocardial infarction (PMI). The present study investigated associations between Pcsk9 and coronary artery lesion severity in PMI patients who underwent coronary angiography (CAG).
This prospective cohort study included young men (age ≤ 45 years, n = 332) with acute MI who underwent CAG between January 2017 and July 2019. Serum Pcsk9 levels and clinical characteristics were evaluated. SYNTAX scores (SYNergy between percutaneous coronary intervention with [paclitaxel-eluting] TAXUS stent and cardiac surgery) were calculated to quantify coronary artery lesions.
Serum Pcsk9 levels were positively associated with SYNTAX scores (r = 0.173, P < 0.05). The diagnostic cutoff value of PSCK9 level was 122.9 ng/mL, yielding an area under the curve (AUC) of 0.63, sensitivity 81%, and specificity 40%. Serum Pcsk9, LDL-C, Apob, NT-proBnp, CK level, and diabetes history were independent predictors of high SYNTAX scores (P < 0.05). After stratifying by serum LDL-C level (cutoff = 2.6 mmol/L), medium-high Pcsk9 levels had increased risk of high SYNTAX scores in patients with high LDL-C (P < 0.05), and higher serum Pcsk9 levels had increased risk of major adverse cardiac events (MACE) after adjusting for confounding factors (P < 0.05).
Serum Pcsk9 levels correlates with severity of coronary artery lesion in PMI patients and may serve as a biomarker for severity of coronary artery stenosis in this patient population, which may contribute to risk stratification.
前蛋白转化酶枯草溶菌素 9（PCSK9）与冠心病的发病和预后相关。然而，PCSK9 是否导致早发心肌梗死（PMI）患者的冠状动脉病变严重程度尚不清楚。本研究调查了接受冠状动脉造影（CAG）的 PMI 患者中 PCSK9 与冠状动脉病变严重程度之间的关系。
本前瞻性队列研究纳入了 2017 年 1 月至 2019 年 7 月间接受 CAG 的年轻男性（年龄≤45 岁，n=332）急性心肌梗死患者。评估了血清 PCSK9 水平和临床特征。计算 SYNTAX 评分（经皮冠状动脉介入治疗[紫杉醇洗脱]TAXUS 支架与心脏手术的协同作用）来量化冠状动脉病变。
血清 PCSK9 水平与 SYNTAX 评分呈正相关（r=0.173，P<0.05）。PCSK9 水平的诊断截断值为 122.9ng/mL，曲线下面积（AUC）为 0.63，灵敏度为 81%，特异性为 40%。血清 PCSK9、LDL-C、Apob、NT-proBnp、CK 水平和糖尿病史是高 SYNTAX 评分的独立预测因子（P<0.05）。按血清 LDL-C 水平分层（截断值=2.6mmol/L）后，中高 PCSK9 水平在 LDL-C 升高的患者中与高 SYNTAX 评分相关（P<0.05），调整混杂因素后，较高的血清 PCSK9 水平与主要不良心脏事件（MACE）的风险增加相关（P<0.05）。
血清 PCSK9 水平与 PMI 患者冠状动脉病变严重程度相关，可能作为该患者人群冠状动脉狭窄严重程度的生物标志物，有助于风险分层。
