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急性心肌梗死患者 PCSK9 与血管内皮功能的关系。

Relationship between PCSK9 and endothelial function in patients with acute myocardial infarction.

机构信息

Maria Cecilia Hospital, GVM Care and Research, via Corriera 1, 48033, Cotignola RA, Italy.

Maria Cecilia Hospital, GVM Care and Research, via Corriera 1, 48033, Cotignola RA, Italy.

出版信息

Nutr Metab Cardiovasc Dis. 2022 Sep;32(9):2105-2111. doi: 10.1016/j.numecd.2022.06.020. Epub 2022 Jul 2.

Abstract

BACKGROUND AND AIMS

While the role of PCSK9 in lipid metabolism is well established, its link with endothelial function is less clear. The aim of the present study is to evaluate the relationship between PCSK9 and endothelial dysfunction in the setting of acute myocardial infarction.

METHODS AND RESULTS

To this purpose, we analyzed the serum of 74 patients with ST-elevation myocardial infarction (STEMI) at the time of admission and after 5 days. Endothelial dysfunction was evaluated as rate of apoptosis (AR) of human umbilical vein endothelial cells incubated with patients' serum. There was a good correlation between PCSK9 and the apoptosis rate values, both at baseline (r = 0.649) and 5-day (r = 0.648). In the 5 days after STEMI, PCSK9 increased significantly (242-327 ng/ml, p < 0.001), while AR did not (p = 0.491). Overall, 21 (28%) patients showed a reduction of PCSK9, and they had a significantly higher decrease of AR as compared to others (-13.87 vs 5.8%, p = 0.002). At the univariable analysis, the 5-day change of PCSK9 resulted to be the only variable associated with the 5-day change of the apoptosis rate (beta 0.217, 95%CI 0.091-0.344, p = 0.001).

CONCLUSION

The variation of endothelial function and PCKS9 in the first days after an acute myocardial infarction are related. Further validation and research are necessary to confirm our findings.

CLINICAL TRIAL

NCT02438085.

摘要

背景与目的

虽然 PCSK9 在脂质代谢中的作用已得到充分证实,但它与内皮功能的关系尚不清楚。本研究旨在评估急性心肌梗死(AMI)患者血清中 PCSK9 与内皮功能障碍之间的关系。

方法和结果

为此,我们分析了 74 例 ST 段抬高型心肌梗死(STEMI)患者入院时和 5 天后的血清。内皮功能障碍通过孵育患者血清的人脐静脉内皮细胞(HUVEC)的凋亡率(AR)进行评估。在基线时(r=0.649)和 5 天时(r=0.648),PCSK9 与凋亡率值之间存在良好的相关性。在 STEMI 后的 5 天内,PCSK9 显著增加(242-327ng/ml,p<0.001),而 AR 没有变化(p=0.491)。总的来说,21 名(28%)患者的 PCSK9 减少,与其他人相比,AR 的下降幅度明显更高(-13.87% vs 5.8%,p=0.002)。在单变量分析中,PCSK9 的 5 天变化是唯一与 AR 的 5 天变化相关的变量(β0.217,95%CI 0.091-0.344,p=0.001)。

结论

急性心肌梗死后内皮功能和 PCSK9 的变化相关。需要进一步的验证和研究来证实我们的发现。

临床试验

NCT02438085。

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