Fig. 1Associations between serum proprotein convertase subtilisin/kexin type 9 (PCSK9) concentrations and numbers of involved arteries identified by coronary angiography. NS, not significant. aP<0.05.
Table 1Baseline clinical characteristics of study participants with and without coronary angiographic lesions
Characteristic |
No lesion (n=21)a
|
Lesion (n=100)b
|
P value |
Age, yr |
56.0±9.7 |
61.0±11.6 |
0.06 |
Body mass index, kg/m2
|
23.8±2.3 |
23.7±2.3 |
0.91 |
Systolic blood pressure, mm Hg |
136.8±26.4 |
137.3±25.2 |
0.93 |
Diastolic blood pressure, mm Hg |
78.5±25.7 |
82.1±16.0 |
0.41 |
Past history |
|
|
|
Hypertension |
7 (30) |
50 (50) |
0.16 |
Diabetes |
4 (19) |
26 (26) |
0.50 |
Familial history of IHD |
4 (19) |
10 (10) |
0.24 |
Smoking |
14 (67) |
61 (61) |
0.63 |
Biochemistry |
|
|
|
White blood cells, /µL |
7,066.7±2,176.8 |
10,227.5±3,669.2 |
<0.01 |
Total cholesterol, mg/dL |
161.3±28.4 |
181.0±45.2 |
0.01 |
HDL-C, mg/dL |
44.5±15.0 |
44.1±11.8 |
0.37 |
Triglycerides, mg/dL |
128.2±59.3 |
117.3±62.4 |
0.46 |
LDL-C, mg/dL |
100.1±22.5 |
121.0±43.9 |
0.03 |
Aspartate transaminase, IU/L |
26.0±12.9 |
56.5±78.1 |
<0.01 |
Alanine transaminase, IU/L |
25.9±17.5 |
29.2±16.7 |
0.42 |
Creatinine, mg/dL |
0.88±0.17 |
0.92±0.25 |
0.50 |
eGFR, mL/min/1.73 m2
|
100.6±26.1 |
100.7±52.9 |
0.90 |
Ischemic heart disease |
|
|
|
Left ventricular ejection fraction, % |
58.0±7.4 |
49.7±10.1 |
<0.01 |
Creatine kinase-MB, ng/mL |
2.0±5.2 |
34.7±68.7 |
<0.01 |
Troponin I, ng/mL |
0.21±0.82 |
36.28±69.31 |
<0.01 |
hs-CRP, mg/L |
0.56±0.92 |
1.23±2.14 |
0.02 |
NT-proBNP, pg/mL |
263.1±878.8 |
904.8±1,526.0 |
0.01 |
Biomarker |
|
|
|
PCSK9, ng/mL |
176.0±63.0 |
221.6±68.3 |
<0.01 |
Table 2Baseline clinical characteristics of study participants stratified into tertiles according to serum levels of PCSK9
Characteristic |
Tertile 1 (n=40) |
Tertile 2 (n=40) |
Tertile 3 (n=41) |
P for trend |
Age, yr |
59.5±10.8 |
59.9±11.7 |
60.9±12.0 |
0.855 |
Body mass index, kg/m2
|
24.4±2.1 |
23.8±2.6 |
23.1±2.6 |
0.075 |
P=0.020a
|
Systolic blood pressure, mm Hg |
133.1±20.4 |
139.7±28.7 |
138.7±26.1 |
0.468 |
Diastolic blood pressure, mm Hg |
75.9±17.1 |
83.9±17.1 |
84.4±18.9 |
0.061 |
P=0.039a
|
Past history |
|
|
|
|
Hypertension |
20 (50) |
17 (43) |
20 (49) |
0.775 |
Diabetes |
13 (33) |
9 (23) |
8 (20) |
0.374 |
Familial history of ischemic heart disease |
4 (10) |
7 (18) |
3 (7) |
0.339 |
Smoking |
24 (60) |
27 (68) |
24 (59) |
0.679 |
Biochemistry |
|
|
|
|
White blood cells, /μL |
7,068.5±4,423.4 |
6,514.2±2,661.7 |
6,437.7±2,970.7 |
0.669 |
Total cholesterol, mg/dL |
173.1±34.6 |
171.0±42.2 |
188.4±50.4 |
0.141 |
HDL-C, mg/dL |
43.5±13.3 |
42.7±9.9 |
46.4±13.5 |
0.362 |
Triglycerides, mg/dL |
119.5±54.6 |
116.0±69.2 |
122.1±62.1 |
0.907 |
LDL-C, mg/dL |
112.8±31.3 |
112.6±32.8 |
126.3±55.4 |
0.236 |
Aspartate transaminase, IU/L |
41.8±41.3 |
47.2±41.3 |
59.5±93.2 |
0.589 |
Alanine transaminase, IU/L |
28.9±18.9 |
29.2±15.0 |
27.3±16.7 |
0.891 |
Creatinine, mg/dL |
0.93±0.17 |
0.88±0.24 |
0.93±0.30 |
0.639 |
eGFR, mL/min/1.73 m2
|
92.5±19.1 |
108.5±72.5 |
101.0±49.2 |
0.347 |
Ischemic heart disease |
|
|
|
|
Left ventricular ejection fraction, % |
53.5±9.6 |
50.7±10.7 |
49.5±11.1 |
0.216 |
Creatine kinase-MB, ng/mL |
34.3±67.4 |
31.8±66.7 |
21.3±57.4 |
0.624 |
Troponin I, ng/mL |
40.0±91.1 |
56.3±36.5 |
23.9±53.9 |
0.483 |
hs-CRP, mg/L |
0.96±1.98 |
0.90±1.45 |
1.47±2.43 |
0.379 |
NT-proBNP, pg/mL |
327.6±606.9 |
943.5±1,745.0 |
1,088.4±1,626.5 |
0.045 |
P=0.008a
|
Biomarker |
|
|
|
|
PCSK9, ng/mL |
144.9±23.1 |
199.5±15.0 |
294.7±45.3 |
<0.001 |
P<0.001a
|
CAG findings |
|
|
|
|
CAG lesion + |
29 (73) |
33 (83) |
38 (93) |
0.057 |
P=0.016a
|
No. of involved coronary arteries (0/1/2/3) |
11/12/10/7 |
7/15/10/8 |
3/15/9/14 |
0.080 |
P=0.031a
|
Severity score |
|
|
|
|
SYNTAX |
12.3±11.3 |
11.1±10.2 |
16.2±9.5 |
0.065 |
GRACE |
71.0±49.5 |
82.0±47.2 |
94.9±40.0 |
0.068 |
P=0.020a
|
Table 3Odds ratios for the presence of one or more coronary angiographic lesions in patients in different PCSK9 tertiles
|
Tertile 1, OR |
Tertile 2, OR (95% CI) |
Tertile 3 |
P for trend |
OR (95% CI) |
P value |
Unadjusted |
1 (reference) |
1.788 (0.613–5.218) |
4.805 (1.227–18.814) |
0.024a
|
0.020 |
Model 1 |
1 (reference) |
1.853 (0.614–5.592) |
5.349 (1.287–22.223) |
0.021a
|
0.018 |
Model 2 |
1 (reference) |
2.688 (0.894–8.985) |
7.468 (1.582–35.249) |
0.011a
|
0.009 |
Table 4Associations between serum PCSK9 concentrations and scores indicating the severity of coronary artery occlusion
|
βstandard
|
P value |
SYNTAX score |
|
|
Unadjusted |
0.191 |
0.035 |
Model 1 |
0.196 |
0.041 |
Model 2 |
0.204 |
0.037 |
GRACE score |
|
|
Unadjusted |
0.266 |
0.003 |
Model 1 |
0.203 |
0.009 |
Model 2 |
0.214 |
0.007 |