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      Association of circulating proprotein convertase subtilisin/kexin type 9 concentration, prothrombin time and cardiovascular outcomes: a prospective cohort study

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          Abstract

          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.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12959-021-00344-0.

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          Most cited references 37

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          Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease

          Evolocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9) and lowers low-density lipoprotein (LDL) cholesterol levels by approximately 60%. Whether it prevents cardiovascular events is uncertain.
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            Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome

            Patients who have had an acute coronary syndrome are at high risk for recurrent ischemic cardiovascular events. We sought to determine whether alirocumab, a human monoclonal antibody to proprotein convertase subtilisin-kexin type 9 (PCSK9), would improve cardiovascular outcomes after an acute coronary syndrome in patients receiving high-intensity statin therapy.
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              • Article: not found

              The hemostatic system as a modulator of atherosclerosis.

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                Author and article information

                Contributors
                fuwaizcg@126.com
                lijianjun938@126.com
                Journal
                Thromb J
                Thromb J
                Thrombosis Journal
                BioMed Central (London )
                1477-9560
                22 November 2021
                22 November 2021
                2021
                : 19
                Affiliations
                GRID grid.506261.6, ISNI 0000 0001 0706 7839, Cardiometabolic Medicine Center, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, , Chinese Academy of Medical Sciences and Peking Union Medical College, ; No 167 BeiLiShi Road, XiCheng District, Beijing, 100037 China
                Article
                344
                10.1186/s12959-021-00344-0
                8607723
                4a9beae1-31c6-40e9-9a70-b0f75cbaddbe
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                Funding
                Funded by: Capital Health Development Fund
                Award ID: 201614035
                Award Recipient :
                Funded by: Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences
                Award ID: 2016-I2M-1-011
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2021

                Cardiovascular Medicine

                pcsk9, coagulation, pt, atherosclerosis, cardiovascular risks

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