Key result
The E670G polymorphism in the PCSK9 gene was significantly associated with an increased risk of major adverse cardio-cerebrovascular events (HR 45.40) in STEMI patients over a 6-month follow-up.
Why the study?
MACCE rates remain high in STEMI despite pharmacologic and interventional advances, and events may be related to PCSK9 polymorphisms.
Does the presence of PCSK9 E670G and R46L polymorphisms increase the risk of MACCE in STEMI patients undergoing primary PCI?
Cohort (n=423)
Blinded outcome assessment
No
Does the presence of PCSK9 E670G and R46L polymorphisms increase the risk of MACCE in STEMI patients undergoing primary PCI?
Hazard Ratio: 45.4 (95% CI 5.3–390.3)
Absolute Event Rate: 88.9% vs 13.8%
p-value: p=0.00
The PCSK9 E670G polymorphism is strongly associated with an increased risk of MACCE at 6 months in STEMI patients undergoing primary PCI.
E670G variant may flag high MACCE risk in STEMI; leaves open whether genotyping refines risk models or therapy.
Major adverse cardio-cerebrovascular events (MACCE) in ST-segment elevation myocardial infarction (STEMI) are still high, although there have been advances in pharmacology and interventional procedures. Proprotein convertase subtilisin/Kexin type 9 (PCSK9) is a serine protease regulating lipid metabolism associated with inflammation in acute coronary syndrome. The MACCE is possibly related to polymorphisms in PCSK9. A prospective cohort observational study was designed to confirm the association between polymorphism of E670G and R46L in the PCSK9 gene with MACCE in STEMI. The Cox proportional hazards model and Spearman correlation were utilized in the study. The Genotyping of PCSK9 and ELISA was assayed. Sixty-five of 423 STEMI patients experienced MACCE in 6 months. The E670G polymorphism in PCSK9 was associated with MACCE (hazard ratio = 45.40; 95% confidence interval: 5.30–390.30; p = 0.00). There was a significant difference of PCSK9 plasma levels in patients with previous statin consumption (310 [220–1,220] pg/mL) versus those free of any statins (280 [190–1,520] pg/mL) (p = 0.001). E670G polymorphism of PCSK9 was associated with MACCE in STEMI within a 6-month follow-up. The plasma PCSK9 level was higher in statin users.
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Santoso et al. (2021) conducted a cohort in ST-Segment Elevation Myocardial Infarction (STEMI) (n=423). PCSK9 E670G polymorphism (AG heterozygote) vs. Wild type (AA) was evaluated on Major adverse cardio-cerebrovascular events (MACCE) within 6 months (HR 45.40, 95% CI 5.30-390.30, p=0.00). The E670G polymorphism in the PCSK9 gene was significantly associated with an increased risk of major adverse cardio-cerebrovascular events (HR 45.40) in STEMI patients over a 6-month follow-up.
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