Endocrine Abstracts

Proprotein convertase subtilisin/kexin type 9 (PCSK9), a circulating protein that promotes degradation of the low density lipoprotein (LDL) receptor, has been emerged as a novel therapeutic target for the dyslipidemia. It is well known that the pathogenesis of cardiovascular disease (CVD) involves lipid metabolism alteration, but the predictive value of circulating PCSK9 level concerning coronary disease severity is largely unknown. The main objective of this study is to determine whether circulating PCSK9 concentration is linked to coronary damage severity in patients with acute coronary syndrome (ACS). We studied 137 patients with ACS who underwent coronary angiography. The study population was divided into two groups depending on the presence of coronary artery lesion (lesion (+): n=112, lesion (−): n=25). Baseline characteristics and PCSK9 levels were measured and coronary lesions were evaluated using the SYNTAX scoring system. After adjustment for established CVD risk factors including age, body mass index (BMI), total cholesterol and low-density lipoprotein-cholesterol (LDL), ACS patients with coronary artery lesion have significantly higher PCSK9 levels than patients without lesion (178.26±63.9 ng/ml vs. 223.0±76.1 ng/ml, P=0.026). Spearman’s correlations revealed that PCSK9 was positively associated with the number of involved coronary artery (Pearson coefficient, 0.034; P=0.01) and the global registry of acute coronary events (GRACE) risk score which is a risk prediction tool applicable for ACS patients (Pearson coefficient, 0.209; P=0.015). Furthermore, we found that plasma PCSK9 level was positively correlated with SYNTAX score (Spearman’s R=0.115, P=0.048). In the present study, we show that Serum PCSK9 concentration is associated with angiographic severity of ACS and GRACE score after adjustments for established CVD risk factors. Further studies are needed to confirm this observation.