title: Risk prediction with proprotein convertase subtilisin/kexin type 9 (PCSK9) in patients with stable coronary disease on statin treatment.
abstract: BACKGROUND
  Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a regulator of LDL-cholesterol receptor homeostasis and emerges as a therapeutic target in the prevention of cardiovascular (CV) disease. This prospective cohort study analyzes risk prediction with PCSK9 serum concentrations in patients with stable coronary artery disease (CAD) on statin treatment.
  
  
  RESULTS
  Fasting PCSK9 concentrations were measured in 504 consecutive patients with stable CAD confirmed by angiography. Oral glucose tolerance tests were performed in all patients without known diabetes. Patients were followed up for 48months. The primary outcome was the composite of cardiovascular death and unplanned cardiovascular hospitalization. Serum concentrations of PCSK9 predicted CV outcomes (PCSK9>622 ng/ml vs. <471 ng/ml: HR 1.55, 95%-CI 1.11-2.16, p=0.009). Higher PCSK9 concentrations were associated with female gender, hypertension, statin treatment, C-reactive protein, HbA1c, insulin, total cholesterol and fasting triglycerides, but not with LDL- or HDL-cholesterol. The association of PCSK9 levels with CV events was reduced after adjustment for fasting TG.
  
  
  CONCLUSIONS
  PCSK9 concentrations predict cardiovascular events in patients with coronary artery disease on statin treatment. Serum triglycerides are correlated with PCSK9 and modify risk prediction by PCSK9.
authors.affiliation: Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Homburg, Saar, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Werner
authors.affiliation: Institut für Klinische Chemie und Laboratoriumsmedizin, Universitätsklinikum Freiburg, Freiburg i.Br., Germany.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Hoffmann
authors.affiliation: Institut für Klinische Chemie und Laboratoriumsmedizin, Universitätsklinikum Freiburg, Freiburg i.Br., Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Winkler
authors.affiliation: Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Homburg, Saar, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.affiliation: Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Homburg, Saar, Germany. Electronic address: ulrich.laufs@uks.eu.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Laufs
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood / Q000378:metabolism; D003324:Coronary Artery Disease / Q000097:blood* / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases / Q000097:blood* / Q000378:metabolism; D011446:Prospective Studies; D012306:Risk; D012697:Serine Endopeptidases / Q000097:blood* / Q000378:metabolism
chemical_list: D002097:C-Reactive Protein; D002784:Cholesterol; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007328:Insulin; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases; D012697:Serine Endopeptidases; C517652:hemoglobin A1c protein, human; C472125:PCSK9 protein, human
keywords: Coronary artery disease; PCSK9; Risk prediction; Statins; Triglycerides