Proprotein convertase subtilisin kexin type 9 and main artery atherosclerosis in patients with arterial hypertension.

Abstract

Aim of our investigation is to study the relationship between the level of proprotein convertase subtilisin kexin type 9 (PCSK9) and atherosclerotic process of coronary and brachiocephalic arteries in patients with arterial hypertension (AH). Our investigation was performed in regional railway hospital. In our investigation we included 161 male train drivers who had AH with achieved target grades 1-2. All patients were performed laboratory tests including cholesterol, LDL-C, triglycerides, glucose, hemostasiograms, PCSK9. Patients were divided into groups up to the PCSK9 level: in group 1 (N.=41) we included patients with PCSK9 level 108-250 ng/mL; group 2 (N.=37) 251-400 ng/mL; group 3 (N.=45) 420-560 ng/mL and group 4 (N.=38) 580-860 ng/mL. All patients were performed coronary angiography, ultrasound Doppler of brachiocephalic arteries, electrocardiography, transthoracic echocardiography. The groups of the patients were identical in age, Body Mass Index, triglycerides, LDL-C, glucose, cholesterol levels. Also, there was no significant difference in the dependence of PCSK9 level on smoking status (χ2=3.1; P=0.3) and the presence of family history of AH (χ2=0.9; P=0.8). It was found that in the 1st group, patients with normal Body Mass Index had normal carotid intima-media thickness ≤1 mm in most of the cases (34.1%). The severity of brachiocephalic and coronary arteries atherosclerosis was more advanced in the 4th group. The atherosclerotic plaques determine the cardiovascular risk in patients with AH. The level of PCSK9 in male patients is an additional cardiovascular risk factor independent from the traditional risk factors. The PCSK9 level is correlated with atherosclerotic severity process of brachiocephalic arteries (P=0.08; r=0.2). The concentration of PCSK9 in the blood serum more than 580 ng/mL in patients with AH determines more severe coronary arteries atherosclerosis. If more the level of PCSK9 than more cardiovascular risk (P=0.002).