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Letter
Letter: Serum Levels of PCSK9 Are Associated with Coronary Angiographic Severity in Patients with Acute Coronary Syndrome (Diabetes Metab J 2018;42:207-14)
Jin Hwa Kimorcid
Diabetes & Metabolism Journal 2018;42(4):348-349.
DOI: https://doi.org/10.4093/dmj.2018.0135
Published online: August 21, 2018
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Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea.

Corresponding author: Jin Hwa Kim. Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University College of Medicine, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Korea. endocrine@chosun.ac.kr

Copyright © 2018 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Early identification and optimal management of acute coronary syndrome (ACS) are important for improvement of prognosis and reduction of mortality [1]. Easy and non-invasive diagnostic and prognostic methods of ACS may allow physicians to initiate earlier precision strategies to prevent adverse outcome. Several biomarkers including troponin I, N-terminal pro-B type natriuretic peptide, creatinine kinase, and high-sensitivity C-reactive protein are available [23].
Proprotein convertase subtilisin/kexin type 9 (PCSK9) reduces the uptake of low density lipoprotein (LDL) cholesterol by increasing the endosomal and lysosomal degradation of LDL receptor, accompanied by an increase in circulating LDL [45]. PCSK9 has been considered as a promising target for lipid-lowering therapy [6]. Recently, several studies showed the new role of PCSK9 in the pathogenesis of ACS and suggested a potential parameter for decision-making in ACS [789].
In this article entitled "Serum levels of PCSK9 are associated with coronary angiographic severity in patients with acute coronary syndrome," Bae et al. [10] evaluated whether a high level of serum PCSK9 is associated with a high risk and severity of ACS. They showed that serum PCSK9 levels were positively associated with the proportion of patients with coronary angiography lesions after adjustment for multiple variables, suggesting that PCSK9 is a potential biomarker of the severity of coronary artery disease. The authors have clearly showed their results in this manuscript, and this approach is quite valuable and helpful to establish a method for early identification and individual strategies of ACS.
However, these results may not be generalizable to all patients because only male participants were enrolled. I hope for a large multicentre prospective cohort study including both genders, especially considering the menopausal state. I also expect to extend the study to see whether there is an association between the level of PCSK9 and prognosis such as recurrence rate and mortality. Lastly, it would have more valuable if they could compare PCSK9 and other biomarkers of ACS, as the authors mentioned.

CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.

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    • PCSK9 gene participates in the development of primary dyslipidemias
      D Matías-Pérez, AD Pérez-Santiago, MA Sánchez Medina, JJ Alpuche Osorno, IA García-Montalvo
      Balkan Journal of Medical Genetics.2021; 24(1): 5.     CrossRef

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      Letter: Serum Levels of PCSK9 Are Associated with Coronary Angiographic Severity in Patients with Acute Coronary Syndrome (Diabetes Metab J 2018;42:207-14)
      Diabetes Metab J. 2018;42(4):348-349.   Published online August 21, 2018
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