Prognostic value of PCSK9 levels in patients with acute coronary syndromes.

Détails

ID Serval
serval:BIB_6842B885C6D9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Prognostic value of PCSK9 levels in patients with acute coronary syndromes.
Périodique
European heart journal
Auteur⸱e⸱s
Gencer B., Montecucco F., Nanchen D., Carbone F., Klingenberg R., Vuilleumier N., Aghlmandi S., Heg D., Räber L., Auer R., Jüni P., Windecker S., Lüscher T.F., Matter C.M., Rodondi N., Mach F.
ISSN
1522-9645 (Electronic)
ISSN-L
0195-668X
Statut éditorial
Publié
Date de publication
07/02/2016
Peer-reviewed
Oui
Volume
37
Numéro
6
Pages
546-553
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication types: Clinical Trial ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't

Résumé
Proprotein convertase subtilisin kexin 9 (PCSK9) is an emerging target for the treatment of hypercholesterolaemia, but the clinical utility of PCSK9 levels to guide treatment is unknown. We aimed to prospectively assess the prognostic value of plasma PCSK9 levels in patients with acute coronary syndromes (ACS).
Plasma PCSK9 levels were measured in 2030 ACS patients undergoing coronary angiography in a Swiss prospective cohort. At 1 year, the association between PCSK9 tertiles and all-cause death was assessed adjusting for the Global Registry of Acute Coronary Events (GRACE) variables, as well as the achievement of LDL cholesterol targets of <1.8 mmol/L. Patients with higher PCSK9 levels at angiography were more likely to have clinical familial hypercholesterolaemia (rate ratio, RR 1.21, 95% confidence interval, CI 1.09-1.53), be treated with lipid-lowering therapy (RR 1.46, 95% CI 1.30-1.63), present with longer time interval of chest pain (RR 1.29, 95% CI 1.09-1.53) and higher C-reactive protein levels (RR 1.22, 95% CI 1.16-1.30). PCSK9 increased 12-24 h after ACS (374 ± 149 vs. 323 ± 134 ng/mL, P < 0.001). At 1 year follow-up, HRs for upper vs. lower PCSK9-level tertiles were 1.13 (95% CI 0.69-1.85) for all-cause death and remained similar after adjustment for the GRACE score. Patients with higher PCSK9 levels were less likely to reach the recommended LDL cholesterol targets (RR 0.81, 95% CI 0.66-0.99).
In ACS patients, high initial PCSK9 plasma levels were associated with inflammation in the acute phase and hypercholesterolaemia, but did not predict mortality at 1 year.

Mots-clé
Acute Coronary Syndrome/drug therapy, Acute Coronary Syndrome/enzymology, Acute Coronary Syndrome/mortality, Biomarkers/blood, Cholesterol, LDL/drug effects, Cholesterol, LDL/metabolism, Female, Humans, Hyperlipoproteinemia Type II/drug therapy, Hyperlipoproteinemia Type II/mortality, Male, Middle Aged, Proprotein Convertase 9/antagonists & inhibitors, Proprotein Convertase 9/blood, Prospective Studies
Pubmed
Open Access
Oui
Création de la notice
21/01/2016 11:35
Dernière modification de la notice
20/08/2019 14:23
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