Abstract
BackgroundPlasma PCSK9 levels was positively associated with low-density lipoprotein (LDL) cholesterol (LDL-C) and atherosclerosis, while PCSK9 may also be implicated in the metabolism of lipoprotein subfractions. The study was to examine the association of plasma PCSK9 with lipoprotein subfractions in patients with stable coronary artery disease (CAD).MethodsA total of 281 consecutive, stable CAD patients who were not treated with lipid-lowering drugs were enrolled. The baseline clinical characteristics were collected, the plasma PCSK9 levels were determined using ELISA, and the LDL and high-density lipoprotein (HDL) subfractions were analyzed by Lipoprint System. The association of plasma PCSK9 levels with the lipoprotein subfractions was investigated.ResultsIn the overall population, plasma PCSK9 levels were positively associated with the concentration of LDL-C, intermediate LDL-C, small LDL-C, and LDL score, while negatively correlated with mean LDL particle size. PCSK9 levels were positively associated with the concentration of HDL-C, intermediate HDL-C and small HDL-C. Multivariable regression analysis revealed that the plasma PCSK9 levels were significantly and independently associated with the concentration of intermediate LDL-C (β = 0.152, p = 0.013), small LDL-C (β = 0.179, p = 0.004), LDL score (β = 0.121, p = 0.043), and mean LDL particle size (β = -0.130, p = 0.035), while not HDL subfractions. Interestingly, when investigated in male and female patients separately, these relationships were only found in male but not in female, and the small HDL-C exhibited an association with PCSK9 levels in male patients (β = 0.149, p = 0.045).ConclusionsPCSK9 levels were independently associated with the changes of lipoprotein subfractions, suggesting a potential interaction between PCSK9 and lipoprotein subfractions in CAD.
Highlights
Coronary artery disease (CAD) is one of the leading causes of death worldwide
Many studies have shown that the smaller low-density lipoprotein (LDL) particles are more atherogenic than the larger ones, and a higher LDL particle number was consistently associated with increased risk for cardiovascular disease independent of other lipid measurements [12,13]
PCSK9 was positively correlated with intermediate, small LDL-C, and LDL score, while not with large LDL-C and mean LDL particle size
Summary
It is well known that hypercholesterolemia is a major pathogenic risk factor for CAD, and it increases the incidence of myocardial infarction and death [1]. Many studies have shown that the smaller LDL particles are more atherogenic than the larger ones, and a higher LDL particle number was consistently associated with increased risk for cardiovascular disease independent of other lipid measurements [12,13]. Little is known about the relationship of plasma PSCK9 and LDL or HDL particles. The present study was, to investigate the potential relationship between plasma PCSK9 levels and LDL and HDL subfractions in patients with stable CAD without statins therapy. The study was to examine the association of plasma PCSK9 with lipoprotein subfractions in patients with stable coronary artery disease (CAD)
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