The combination of high PCSK9 and low prothrombin time was associated with a significantly higher risk of major adverse cardiovascular events (HR 1.815) compared to low PCSK9 and high prothrombin time.
Cohort (n=2,293)
No
Does high PCSK9 concentration combined with low prothrombin time predict major adverse cardiovascular events in patients with angina-like chest pain?
High circulating PCSK9 levels combined with low prothrombin time independently predict an increased risk of major adverse cardiovascular events in untreated patients with chest pain.
Hazard Ratio: 1.815 (95% CI 1.193–2.762)
Absolute Event Rate: 11.4% vs 5.4%
p-value: p=0.005
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is considered to have multiple roles in the development of atherosclerosis, which is recently reported to participate in the thrombotic process. We aimed to examine the relationship between PCSK9 concentration, coagulation indexes and cardiovascular events. METHODS: A total of 2293 consecutive patients with angina-like chest pain and without lipid-lowering drugs treatment were enrolled and followed up for major adverse cardiovascular events (MACEs). Circulating PCSK9 concentration was determined by ELISA. The routine coagulation tests including activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time were performed. The associations between PCSK9 concentration, routine coagulation indicators and MACEs were analyzed. RESULTS: Patients with high PCSK9 levels had lower PT and APTT levels (all p < 0.05). However, PCSK9 concentration was only independently and negatively correlated with PT (β = - 0.115, p < 0.001). During a mean of 38.3 months, 186 (8.1%) MACEs were occurred. Multiple Cox regression analysis indicated high PCSK9 or low PT levels as risk factors related to MACEs. When the prognosis was analyzed by the combination of PCSK9 and PT levels, patients with high PCSK9 and low PT had higher incidence of MACEs compared to those with low PCSK9 and high PT. CONCLUSIONS: Our study firstly suggested that PCSK9 concentration was negatively correlated with plasma levels of PT. Furthermore, high PCSK9 and low PT were associated with MACEs and the combination of PCSK9 with PT had an addictive effect on predicting cardiovascular outcomes in patients with chest pain, which was useful for further subdivision of cardiovascular risks.
Peng et al. (Mon,) conducted a cohort in Angina-like chest pain (n=2,293). High PCSK9 concentration and low prothrombin time vs. Low PCSK9 concentration and high prothrombin time was evaluated on Major adverse cardiovascular events (MACEs) (HR 1.815, 95% CI 1.193-2.762, p=0.005). The combination of high PCSK9 and low prothrombin time was associated with a significantly higher risk of major adverse cardiovascular events (HR 1.815) compared to low PCSK9 and high prothrombin time.
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