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Circulating PCSK9 Level and Risk of Cardiovascular Events and Death in Hemodialysis Patients

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising new target for the prevention of cardiovascular (CV) events. However, the clinical significance of circulating PCSK9 is unclear in hemodialysis (HD) patients. A total of 353 HD patients were prospectively enrolled from June 2016 to...

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Autores principales: Hwang, Hyeon Seok, Kim, Jin Sug, Kim, Yang Gyun, Lee, So-Young, Ahn, Shin Young, Lee, Hong Joo, Lee, Dong-Young, Lee, Sang Ho, Moon, Ju Young, Jeong, Kyung Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019341/
https://www.ncbi.nlm.nih.gov/pubmed/31963408
http://dx.doi.org/10.3390/jcm9010244
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author Hwang, Hyeon Seok
Kim, Jin Sug
Kim, Yang Gyun
Lee, So-Young
Ahn, Shin Young
Lee, Hong Joo
Lee, Dong-Young
Lee, Sang Ho
Moon, Ju Young
Jeong, Kyung Hwan
author_facet Hwang, Hyeon Seok
Kim, Jin Sug
Kim, Yang Gyun
Lee, So-Young
Ahn, Shin Young
Lee, Hong Joo
Lee, Dong-Young
Lee, Sang Ho
Moon, Ju Young
Jeong, Kyung Hwan
author_sort Hwang, Hyeon Seok
collection PubMed
description Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising new target for the prevention of cardiovascular (CV) events. However, the clinical significance of circulating PCSK9 is unclear in hemodialysis (HD) patients. A total of 353 HD patients were prospectively enrolled from June 2016 to August 2019 in a K-cohort. Plasma PCSK9 level was measured at the time of study enrollment. The primary endpoint was defined as a composite of CV event and death. Plasma PCSK9 level was positively correlated with total cholesterol level in patients with statin treatment. Multivariate linear regression analysis revealed that baseline serum glucose, albumin, total cholesterol, and statin treatment were independent determinants of circulating PCSK9 levels. Cumulative rates of composite and CV events were significantly higher in patients with tertile 3 PCSK9 (p = 0.017 and p = 0.010, respectively). In multivariate Cox-regression analysis, PCSK9 tertile 3 was associated with a 1.97-fold risk of composite events (95% CI, 1.13–3.45), and it was associated with a 2.31-fold risk of CV events (95% CI, 1.17–4.59). In conclusion, a higher circulating PCSK9 level was independently associated with incident CV events and death in HD patients. These results suggest the importance of future studies regarding the effect of PCSK9 inhibition.
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spelling pubmed-70193412020-03-09 Circulating PCSK9 Level and Risk of Cardiovascular Events and Death in Hemodialysis Patients Hwang, Hyeon Seok Kim, Jin Sug Kim, Yang Gyun Lee, So-Young Ahn, Shin Young Lee, Hong Joo Lee, Dong-Young Lee, Sang Ho Moon, Ju Young Jeong, Kyung Hwan J Clin Med Article Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising new target for the prevention of cardiovascular (CV) events. However, the clinical significance of circulating PCSK9 is unclear in hemodialysis (HD) patients. A total of 353 HD patients were prospectively enrolled from June 2016 to August 2019 in a K-cohort. Plasma PCSK9 level was measured at the time of study enrollment. The primary endpoint was defined as a composite of CV event and death. Plasma PCSK9 level was positively correlated with total cholesterol level in patients with statin treatment. Multivariate linear regression analysis revealed that baseline serum glucose, albumin, total cholesterol, and statin treatment were independent determinants of circulating PCSK9 levels. Cumulative rates of composite and CV events were significantly higher in patients with tertile 3 PCSK9 (p = 0.017 and p = 0.010, respectively). In multivariate Cox-regression analysis, PCSK9 tertile 3 was associated with a 1.97-fold risk of composite events (95% CI, 1.13–3.45), and it was associated with a 2.31-fold risk of CV events (95% CI, 1.17–4.59). In conclusion, a higher circulating PCSK9 level was independently associated with incident CV events and death in HD patients. These results suggest the importance of future studies regarding the effect of PCSK9 inhibition. MDPI 2020-01-17 /pmc/articles/PMC7019341/ /pubmed/31963408 http://dx.doi.org/10.3390/jcm9010244 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hwang, Hyeon Seok
Kim, Jin Sug
Kim, Yang Gyun
Lee, So-Young
Ahn, Shin Young
Lee, Hong Joo
Lee, Dong-Young
Lee, Sang Ho
Moon, Ju Young
Jeong, Kyung Hwan
Circulating PCSK9 Level and Risk of Cardiovascular Events and Death in Hemodialysis Patients
title Circulating PCSK9 Level and Risk of Cardiovascular Events and Death in Hemodialysis Patients
title_full Circulating PCSK9 Level and Risk of Cardiovascular Events and Death in Hemodialysis Patients
title_fullStr Circulating PCSK9 Level and Risk of Cardiovascular Events and Death in Hemodialysis Patients
title_full_unstemmed Circulating PCSK9 Level and Risk of Cardiovascular Events and Death in Hemodialysis Patients
title_short Circulating PCSK9 Level and Risk of Cardiovascular Events and Death in Hemodialysis Patients
title_sort circulating pcsk9 level and risk of cardiovascular events and death in hemodialysis patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019341/
https://www.ncbi.nlm.nih.gov/pubmed/31963408
http://dx.doi.org/10.3390/jcm9010244
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