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Cardiovascular Diabetology
Published in: Cardiovascular Diabetology 1/2019

Open Access 01-12-2019 | CT Angiography | Original investigation

Association of PCSK9 plasma levels with metabolic patterns and coronary atherosclerosis in patients with stable angina

Authors: Chiara Caselli, Serena Del Turco, Rosetta Ragusa, Valentina Lorenzoni, Michiel De Graaf, Giuseppina Basta, Arthur Scholte, Raffaele De Caterina, Danilo Neglia

Published in: Cardiovascular Diabetology | Issue 1/2019

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Abstract

Objective

Aim of this study was to evaluate the relationship of plasma PCSK9 with metabolic and inflammatory profile and coronary atherosclerotic burden in patients with suspected CAD enrolled in the EVINCI study.

Methods

PCSK9 was measured in 539 patients (60.3 ± 8.6 years, 256 males) with symptoms of CAD characterized by risk factors, bio-humoral profiles, and treatment. N = 412 patients underwent coronary computed tomography angiography (CTA) to assess the presence and characteristics of coronary atherosclerosis. A CTA score, combining extent, severity, composition, and location of plaques was computed.

Results

Patients were divided according to PCSK9 quartiles: I (< 136 ng/mL), II–III (136–266 ng/mL), and IV quartile (> 266 ng/mL). Compared with patients in quartile IV, patients in quartile I had a higher prevalence of the metabolic syndrome and higher values of body mass index. LDL- and HDL-cholesterol were significantly lower in patients in the quartile I than in those in quartile IV. Coronary CTA documented normal vessels in 30% and obstructive CAD in 35% of cases without differences among PCSK9 quartiles. Compared with patients with the highest levels, patients with the lowest PCSK9 levels had a higher CTA score mainly due to higher number of mixed non-obstructive coronary plaques. At multivariable analysis including clinical, medications, and lipid variables, PCSK9 was an independent predictor of the CTA score (coefficient − 0.129, SE 0.03, P < 0.0001), together with age, male gender, statins, interleukin-6, and leptin.

Conclusion

In patients with stable CAD, low PCSK9 plasma levels are associated with a particular metabolic phenotype (low HDL cholesterol, the metabolic syndrome, obesity, insulin resistance and diabetes) and diffuse non-obstructive coronary atherosclerosis.
Trial registration ClinicalTrials.gov NCT00979199. Registered September 17, 2009
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Metadata
Title
Association of PCSK9 plasma levels with metabolic patterns and coronary atherosclerosis in patients with stable angina
Authors
Chiara Caselli
Serena Del Turco
Rosetta Ragusa
Valentina Lorenzoni
Michiel De Graaf
Giuseppina Basta
Arthur Scholte
Raffaele De Caterina
Danilo Neglia
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2019
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-019-0949-3

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