Plasma proprotein convertase subtilisin/kexin type 9 concentration and recurrent cardiovascular events in patients with familial hypercholesterolemia.

Autor:	Cao YX; State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and National Center for Cardiovascular Diseases, China., Liu HH; State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and National Center for Cardiovascular Diseases, China., Jin JL; State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and National Center for Cardiovascular Diseases, China., Sun D; State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and National Center for Cardiovascular Diseases, China., Guo YL; State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and National Center for Cardiovascular Diseases, China., Wu NQ; State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and National Center for Cardiovascular Diseases, China., Zhu CG; State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and National Center for Cardiovascular Diseases, China., Xu RX; State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and National Center for Cardiovascular Diseases, China., Sun J; State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and National Center for Cardiovascular Diseases, China., Santos RD; Heart Institute (InCor), University of Sao Paulo Medical School Hospital, Brazil.; Hospital Israelita Albert Einstein, Brazil., Li JJ; State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and National Center for Cardiovascular Diseases, China.
Jazyk:	angličtina
Zdroj:	European journal of preventive cardiology [Eur J Prev Cardiol] 2021 Apr 23; Vol. 28 (3), pp. 272-279. Date of Electronic Publication: 2019 Oct 11.
DOI:	10.1177/2047487319880985
Abstrakt:	Aims: Familial hypercholesterolemia patients are characterized by early onset of coronary artery calcification and atherosclerosis, and high incidence of cardiovascular events. Plasma proprotein convertase subtilisin/kexin type 9 was reported to be a predictor for cardiovascular risk in the general population. However, its prognostic value for predicting recurrent cardiovascular events in familial hypercholesterolemia patients remains undetermined. Methods: A total of 249 patients with molecularly and/or clinically (Dutch Lipid Clinic Network score > 6) defined familial hypercholesterolemia who had experienced a first cardiovascular event were consecutively included and plasma proprotein convertase subtilisin/kexin type 9 concentrations were measured by enzyme-linked immunosorbent assay. Coronary artery calcification was measured using Agatston method and coronary severity was assessed by Gensini score, respectively. All patients received standard lipid-lowering therapy and were followed-up for recurrent cardiovascular events. Univariate and multivariate regression and Cox analyses was used to calculate hazard ratios with 95% confidence interval. Results: Circulating proprotein convertase subtilisin/kexin type 9 concentrations were positively associated with coronary artery calcification scores and Gensini score by both univariate and multivariate analyses. During a mean follow-up of 43 ± 19 months, 29 (11.51%) recurrent cardiovascular events occurred. Kaplan-Meier analysis showed that patients with the highest proprotein convertase subtilisin/kexin type 9 levels had the lowest event-free survival time. Multivariable Cox regression analysis revealed that proprotein convertase subtilisin/kexin type 9 was independently associated with recurrent cardiovascular events (hazard ratio: 1.45, 95% confidence interval: 1.11-1.88). The combination of proprotein convertase subtilisin/kexin type 9 to Cox prediction model led to an enhanced predictive value for recurrent cardiovascular events. Conclusions: Increased level of proprotein convertase subtilisin/kexin type 9 was a significant risk factor of atherosclerosis and independently predicted future recurrent cardiovascular events in familial hypercholesterolemia patients receiving standard lipid-lowering treatment. (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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