Proprotein Convertase Subtilisin/Kexin Type 9 and Systemic Inflammatory Biomarker Pentraxin 3 for Risk Stratification Among STEMI Patients Undergoing Primary PCI

Figures

• 

  Figure 1. Representative cross-sectional optical coherence tomography images. (A) The identification of calcification was the presence of a well-delineated, low-back scattering region (asterisk). (B) Lipid plaque appears as signal-poor and diffusely bordered regions where overlying signal-rich bands (arrow). (C) Macrophages infiltration was defined as a distinct or confluent punctuate, signal-rich region of higher intensity than background speckle noise which creates conspicuous backward shadowing (arrows). (D) Plaque rupture (asterisk) was identified by uncompleted fibrous cap and cavity formation. (E) Plaque erosion identified by thrombus with an intact underlying plaque (arrows). (F) Microvessels was identified by the tubule luminal which without connection to the vessel lumen (arrow). (G) Red thrombus consists by red blood cells; relevant OCT images are characterized as high-back scattering protrusions with signal free shadowing (asterisk). White thrombi consisted by white blood cells and platelets. White thrombi were featured as low-back scattering, signal-rich and billowing projections protruding into the lumen (asterisk). (H) Cholesterol crystal (arrow) identified by backs cattering…

• 

  Figure 2. Flow chart.

• 

  Figure 3. Correlation between PCSK9 and pentraxin 3. Table 4 revealed the Impact of PCSK9 and PTX3 on endpoints among all enrolled cohort by univariable and Multivariable Analyses. Table 5 revealed the Impact of PCSK9 and PTX3 on Major adverse cardiovascular events among plaque rupture and plaque erosion cohort by univariable and Multivariable Analyses.

• 

  Figure 4. Kaplan–Meier Curves of MACE stratified by achieved PCSK9 and PTX3 in the setting of all enrolled cohort or plaque rupture/ plaque erosion. (A), Kaplan–Meier Curves of MACE stratified by achieved PCSK9 and PTX3 in the setting of all enrolled cohort. Test of trend: P = 0.00075. (B), Kaplan–Meier Curves of MACE stratified by achieved PCSK9 and PTX3 in the setting of patients with plaque erosion. Test of trend: P = 0.028. (C), Kaplan–Meier Curves of MACE stratified by achieved PCSK9 and PTX3 in the setting of patients with plaque rupture. Test of trend: P = 0.170.

• 

  Figure 5. The prognostic value of PCSK9. We conducted the area under the receiver operating characteristic curve (ROC) for predicting MACEs to evaluate the diagnostic value of PCSK9 combined with PTX3 after fully adjustment (adjusted factors including gender, age, hypertension, hyperlipidemia, diabetes mellitus, the use of statin, hs-CRP, triglyceride, low-lipid protein). The area under the ROC curve of PCSK9 and PCSK9 combined with PTX3 after fully adjustment was 0.730 (95% CI, 0.650–0.770) and 0.732 (95% CI, 0.671–0.778).