Effect of PCSK9 E670G and R46L Polymorphisms on Major Adverse Cardio-Cerebrovascular Events in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary InterventionFunding This study was funded by the National Cardiovascular Centre—Harapan Kita Hospital, Jakarta—Indonesia, with the grant number: LB. 02.02/XX.8/0224/2019
Major adverse cardio-cerebrovascular events (MACCE) in ST-segment elevation myocardial infarction (STEMI) are still high, although there have been advances in pharmacology and interventional procedures. Proprotein convertase subtilisin/Kexin type 9 (PCSK9) is a serine protease regulating lipid metabolism associated with inflammation in acute coronary syndrome. The MACCE is possibly related to polymorphisms in PCSK9. A prospective cohort observational study was designed to confirm the association between polymorphism of E670G and R46L in the PCSK9 gene with MACCE in STEMI. The Cox proportional hazards model and Spearman correlation were utilized in the study. The Genotyping of PCSK9 and ELISA was assayed.
Sixty-five of 423 STEMI patients experienced MACCE in 6 months. The E670G polymorphism in PCSK9 was associated with MACCE (hazard ratio = 45.40; 95% confidence interval: 5.30–390.30; p = 0.00). There was a significant difference of PCSK9 plasma levels in patients with previous statin consumption (310 [220–1,220] pg/mL) versus those free of any statins (280 [190–1,520] pg/mL) (p = 0.001).
E670G polymorphism of PCSK9 was associated with MACCE in STEMI within a 6-month follow-up. The plasma PCSK9 level was higher in statin users.
KeywordsPCSK9 gene polymorphism - ST-elevation myocardial infarction - major adverse cardio-cerebrovascular events - primary PCI - cardiovascular diseases - high-sensitivity C-reactive protein
All procedures performed in the study involving human participants were following the ethical standards and had been reviewed by the Institutional Review Board and Local Ethics Committee of National Cardiovascular Centre—Harapan Kita Hospital in Jakarta, Indonesia (No: LB.02.01/VII/307/KEP.078/2–18) and conforms to the ethical guidelines of the 1964 Helsinki declaration and its amendments, and the 2016 International Ethical Guidelines for Health-related Research Involving Humans (CIOMS and WHO).
Informed consent was obtained from all individuals included in the study.
18 February 2021 (online)
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