title: Pro-protein convertase subtilisin/kexin 9 concentrations correlate with coronary artery disease atheroma burden in a Pakistani cohort with chronic chest pain.
abstract: OBJECTIVE
  To determine the relationship between proprotein convertase subtilisin kexin 9 (PCSK9) levels and atheroma burden in Pakistanis presenting to an ambulatory centre with chest pain.
  
  
  METHODS
  A prospective matched case-control study of 400 patients selected for presence/absence of angiographic disease referred between 2001 and 2003. A comprehensive cardiovascular disease risk factor profile was assessed including demographics, environmental and biochemical risk factors including insulin resistance and PCSK-9 levels. Coronary atheroma burden was quantified by Gensini score.
  
  
  RESULTS
  In this population, PCSK-9 levels were weakly correlated (r = 0.23) with male gender (p = 0.06) and number of diabetes years (p = 0.09), and inversely with log10 of lipoprotein (a) concentration (p = 0.07) but not LDL-C. In multiple regression analysis, Gensini score was associated with age (p = 0.002), established angina (p = 0.001), duration of diabetes (p = 0.05), low HDL-C (p < 0.001), lipoprotein (a) (p = 0.01), creatinine (p < 0.001), C-Reactive Protein (p = 0.02) and PSCK-9 (p = 0.05) concentrations. PCSK9 added to the regression model. Neither total cholesterol nor LDL-C were significant risk factors in this study.
  
  
  CONCLUSIONS
  Proprotein convertase subtilisin kexin 9 concentrations are correlated with atheroma burden in Indian Asian populations from the sub-continent, not taking statin therapy, independent of LDL-C or other CVD risk factors.
authors.affiliation: Viapath Pathology, Guy's & St. Thomas' Hospitals, London, UK.
authors.forename: T A
authors.initials: TA
authors.lastname: Walton
authors.affiliation: Heartfile, Islamabad, Pakistan.
authors.forename: S
authors.initials: S
authors.lastname: Nishtar
authors.affiliation: Department of Metabolic Medicine/Chemical Pathology, Guy's & St. Thomas' Hospitals, London, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Lumb
authors.affiliation: Department of Metabolic Medicine/Chemical Pathology, Guy's & St. Thomas' Hospitals, London, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Crook
authors.affiliation: Department of Cardiology, Guy's & St. Thomas' Hospitals, London, UK.
authors.forename: M S
authors.initials: MS
authors.lastname: Marber
authors.affiliation: Department of Cardiology, Guy's & St. Thomas' Hospitals, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Gill
authors.affiliation: Department of Metabolic Medicine/Chemical Pathology, Guy's & St. Thomas' Hospitals, London, UK.
authors.forename: A S
authors.initials: AS
authors.lastname: Wierzbicki
mesh_terms: D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology*; D059350:Chronic Pain / Q000175:diagnosis / Q000209:etiology*; D003324:Coronary Artery Disease / Q000150:complications / Q000201:enzymology* / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000201:enzymology* / Q000453:epidemiology; D011379:Prognosis; D000071449:Proprotein Convertase 9 / Q000097:blood*; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; C472125:PCSK9 protein, human; D000071449:Proprotein Convertase 9