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2 "Coronary angiography"
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Serum Levels of PCSK9 Are Associated with Coronary Angiographic Severity in Patients with Acute Coronary Syndrome
Kwi-Hyun Bae, Sung Woo Kim, Yeon-Kyung Choi, Jung Beom Seo, Namkyun Kim, Chang-Yeon Kim, Won Kee Lee, Sungwoo Lee, Jung Guk Kim, In-Kyu Lee, Jang Hoon Lee, Keun-Gyu Park
Diabetes Metab J. 2018;42(3):207-214.   Published online May 2, 2018
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  • 58 Download
  • 26 Web of Science
  • 25 Crossref
AbstractAbstract PDFPubReader   

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a circulating protein that promotes degradation of the low density lipoprotein receptor. PCSK9 has emerged as a target for lipid-lowering therapy, but the predictive value of the serum level of PCSK9 for the severity of coronary disease is largely unknown.


From December 2009 to July 2012, 121 individuals who underwent coronary angiography (CAG) because of clinically suspected acute coronary syndrome were enrolled in this study. Serum levels of PCSK9 and metabolic parameters were measured. SYNTAX (SYNergy between percutaneous coronary intervention with [paclitaxel-eluting] TAXUS stent and cardiac surgery) and GRACE (Global Registry of Acute Coronary Events) scores were calculated.


Individuals with CAG lesions (n=100) had significantly higher levels of PCSK9 than those without lesions (n=21). The study population was stratified into three groups according to serum levels of PCSK9. The odds radio for occurrence of one or more CAG lesions was significantly higher in the group with the highest level of PCSK9 (odds ratio, 7.468; P=0.011) than in the group with the lowest level of PCSK9. Serum PCSK9 was positively associated with the number of involved coronary arteries. Multivariable linear regression indicated that levels of PCSK9 were positively correlated with GRACE risk scores and SYNTAX scores.


Serum PCSK9 concentrations are higher in patients with coronary artery lesions, and are associated with SYNTAX and GRACE scores, suggesting that PCSK9 is a potential biomarker of the severity of coronary artery disease.


Citations to this article as recorded by  
  • Clinical Significance of PCSK9 and Soluble P-selectin in Predicting Major Adverse Cardiovascular Events After Primary Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome
    Yao Yao, Qining Qiu, Xiaoye Li, Zi Wang, Shikun Xu, Qianzhou Lv
    Cardiovascular Innovations and Applications.2024;[Epub]     CrossRef
  • The role of PCSK9 in heart failure and other cardiovascular diseases—mechanisms of action beyond its effect on LDL cholesterol
    Mieczysław Dutka, Karolina Zimmer, Michał Ćwiertnia, Tomasz Ilczak, Rafał Bobiński
    Heart Failure Reviews.2024;[Epub]     CrossRef
  • Serum mature and furin-cleaved proprotein convertase subtilisin/kexin type 9 levels and their association with cardiovascular events in statin-treated patients with cardiovascular disease
    Kiyoshi Hibi, Masaomi Gohbara, Kohei Uemura, Noriaki Iwahashi, Kozo Okada, Hiroshi Iwata, Yoshihiro Fukumoto, Takafumi Hiro, Yukio Ozaki, Satoshi Iimuro, Ichiro Sakuma, Seiji Hokimoto, Katsumi Miyauchi, Yutaka Matsuyama, Yoshihisa Nakagawa, Hisao Ogawa, H
    Journal of Clinical Lipidology.2024;[Epub]     CrossRef
  • Stratification in Heterozygous Familial Hypercholesterolemia: Imaging, Biomarkers, and Genetic Testing
    Pablo Corral, Carlos A. Aguilar Salinas, María Gabriela Matta, Valeria Zago, Laura Schreier
    Current Atherosclerosis Reports.2023; 25(12): 899.     CrossRef
  • Relationship of sortilin and proprotein convertase subtilisin/kexin type 9 in blood serum with the severity of carotid and coronary atherosclerosis in hypertensive patients
    Yu. Yu. Vukolova, I. V. Gubareva
    Russian Journal of Cardiology.2022; 27(2S): 4903.     CrossRef
  • PCSK9 Inhibition could be Effective for Acute Myocardial Infarction
    Baris Gencer, François Mach
    Current Medicinal Chemistry.2022; 29(6): 1016.     CrossRef
  • Peri-event plasma PCSK9 and hsCRP after an acute myocardial infarction correlate with early deterioration of left ventricular ejection fraction: a cohort study
    Lina S. Silva-Bermúdez, Andrea Vargas-Villanueva, Carlos A. Sánchez-Vallejo, Ana C. Palacio, Andrés F. Buitrago, Carlos O. Mendivil
    Lipids in Health and Disease.2022;[Epub]     CrossRef
  • Plasma Levels of Proprotein Convertase Subtilisin/Kexin Type 9 Are Inversely Associated with N-Terminal Pro B-Type Natriuretic Peptide in Older Men and Women
    Francesco Spannella, Federico Giulietti, Roberta Galeazzi, Anna Passarelli, Serena Re, Chiara Di Pentima, Massimiliano Allevi, Paolo Magni, Riccardo Sarzani
    Biomedicines.2022; 10(8): 1961.     CrossRef
  • Sex difference in circulating PCSK9 and its clinical implications
    Fang Jia, Si-Fan Fei, De-Bing Tong, Cong Xue, Jian-Jun Li
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Physiology and role of PCSK9 in vascular disease: Potential impact of localized PCSK9 in vascular wall
    Yanan Guo, Binjie Yan, Yu Gui, Zhihan Tang, Shi Tai, Shenghua Zhou, Xi‐Long Zheng
    Journal of Cellular Physiology.2021; 236(4): 2333.     CrossRef
  • PCSK9 levels do not predict severity and recurrence of cardiovascular events in patients with acute myocardial infarction
    Marianne Zeller, Gilles Lambert, Michel Farnier, Maud Maza, Brice Nativel, Luc Rochette, Catherine Vergely, Yves Cottin
    Nutrition, Metabolism and Cardiovascular Diseases.2021; 31(3): 880.     CrossRef
  • Pcsk9 is associated with severity of coronary artery lesions in male patients with premature myocardial infarction
    Jing Gao, Ya-Nan Yang, Zhuang Cui, Si-Yuan Feng, Jing Ma, Chang-Ping Li, Yin Liu
    Lipids in Health and Disease.2021;[Epub]     CrossRef
  • Circulating Biomarkers for Cardiovascular Disease Risk Prediction in Patients With Cardiovascular Disease
    Yuen-Kwun Wong, Hung-Fat Tse
    Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
  • Association Between Circulating Proprotein Convertase Subtilisin/Kexin Type 9 Concentrations and Cardiovascular Events in Cardiovascular Disease: A Systemic Review and Meta-Analysis
    Jiahui Liu, Fangfang Fan, Xingyu Luo, Wenjun Ji, Yaokun Liu, Yan Zhang, Bo Zheng
    Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
  • PCSK9 in acute coronary syndrome: analysis of associations with clinical and laboratory characteristics
    Yu. A. Drenina, K. Yu. Nikolaev
    Cardiovascular Therapy and Prevention.2020; 19(4): 2484.     CrossRef
  • Relation of Proprotein Convertase Subtilisin/Kexin Type 9 to Cardiovascular Outcomes in Patients Undergoing Percutaneous Coronary Intervention
    Ik Jun Choi, Sungmin Lim, Dongjae Lee, Won Jik Lee, Kwan Yong Lee, Mi-Jeong Kim, Doo Soo Jeon
    The American Journal of Cardiology.2020; 133: 54.     CrossRef
  • A Narrative Review and Expert Panel Recommendations on Dyslipidaemia Management After Acute Coronary Syndrome in Countries Outside Western Europe and North America
    Ashraf Reda, Wael Almahmeed, Idit Dobrecky-Mery, Po-Hsun Huang, Ursulo Juarez-Herrera, Naresh Ranjith, Tobias Sayre, Miguel Urina-Triana
    Advances in Therapy.2020; 37(5): 1754.     CrossRef
  • PCSK9 concentrations in different stages of subclinical atherosclerosis and their relationship with inflammation
    Štefan Tóth, Peter Olexa, Zdenka Hertelyová, Peter Štefanič, Ivan Kopolovets, Peter Berek, Vladimir Filip, Ryan Chakravarty, Monika Široká, Daniel Pella
    Open Chemistry.2020; 18(1): 1011.     CrossRef
  • Association of serum proprotein convertase subtilisin/kexin type 9 with early atherosclerosis in newly diagnosed type 2 diabetes mellitus
    Wen Guo, Yingyun Gong, Jie Li, Pei Qin, Jing Lu, Xiaona Li, Wenfang Zhu, Nianzhen Xu, Hongwen Zhou, Qun Zhang
    Nutrition, Metabolism and Cardiovascular Diseases.2019; 29(8): 815.     CrossRef
  • PCSK9 and atherosclerosis burden in the coronary arteries of patients undergoing coronary angiography
    Yunes Panahi, Mohsen Sadeghi Ghahrodi, Mohsen Jamshir, Mohammad Amin Safarpour, Vanessa Bianconi, Matteo Pirro, Maryam Moshkani Farahani, Amirhossein Sahebkar
    Clinical Biochemistry.2019; 74: 12.     CrossRef
  • Association of PCSK9 plasma levels with metabolic patterns and coronary atherosclerosis in patients with stable angina
    Chiara Caselli, Serena Del Turco, Rosetta Ragusa, Valentina Lorenzoni, Michiel De Graaf, Giuseppina Basta, Arthur Scholte, Raffaele De Caterina, Danilo Neglia
    Cardiovascular Diabetology.2019;[Epub]     CrossRef
  • PCSK9 inhibition and inflammation: A narrative review
    Massimiliano Ruscica, Lale Tokgözoğlu, Alberto Corsini, Cesare R. Sirtori
    Atherosclerosis.2019; 288: 146.     CrossRef
  • 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 Kim
    Diabetes & Metabolism Journal.2018; 42(4): 348.     CrossRef
  • Response: Serum Levels of PCSK9 Are Associated with Coronary Angiographic Severity in Patients with Acute Coronary Syndrome (Diabetes Metab J 2018;42:207-14)
    Sung Woo Kim, Keun-Gyu Park
    Diabetes & Metabolism Journal.2018; 42(4): 350.     CrossRef
  • Serum PCSK9 levels, but not PCSK9 polymorphisms, are associated with CAD risk and lipid profiles in southern Chinese Han population
    Gaojun Cai, Lei Yu, Zhiying Huang, Li Li, Xingli Fu
    Lipids in Health and Disease.2018;[Epub]     CrossRef
Insulin Resistance and severity of coronary artery diseases in Patients with Coronary Artery Diseases.
Dae Jung Kim, Jae Hyun Nam, Dong Hoon Choi, Hyeung Jin Kim, Soo Kyung Kim, Se Hwa Kim, Yumie Rhee, Chul Woo Ahn, Bong Soo Cha, Young Duk Song, Sung Kil Lim, Kyeong Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 2002;26(3):189-198.   Published online June 1, 2002
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  • 19 Download
AbstractAbstract PDF
Insulin resistance (IR) has been identified as a risk factor of atherosclerosis, which may be induced through a mechanism brought about by hypertension, obesity, glucose intolerance and dyslipidemia. The purpose of this study was to investigate the relationship between coronary artery disease (CAD) and insulin resistance. METHODS: Of 92 subjects having undergone coronary angiography 70 with significantly stenotic coronary artery were designated as the CAD group, with the other 22, without stenosis, as the control group. The CAD group was subdivided into 3 smaller groups according to the severity of their CAD; these being 1-vessel disease (group 1, n=31), 2-vessel disease (group 2, n=25), and 3-vessel disease (group 3, n=14). RESULTS: Kitt for patients with CAD was significantly lower than in the control group, and also for those in group 1 compared to groups 2 and 3, 2.72+/-1.29, 2.25+/-0.68 and 2.21+/-0.78%/min, with that of the controls being 3.01+/-1.22%/min p<0.05). There were significant differences between the IR group and the non-IR group in the common carotid artery intima-media thickness (1.09mm vs. 0.87mm, p<0.05), the waist-hip ratio (1.09 vs. 0.93, p<0.05) and the body fat contents (32% vs. 27%, p<0.05).Insulin resistance was assessed by the short insulin tolerance test, and the insulin resistance (IR) group was defined as having a Kitt less than 2.5%/min. CONCLUSION: These results suggest that insulin resistance is an important risk factor for CAD, and is related to the severity of coronary atherosclerosis.

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