[Predictive value of plasma PCSK9 levels in acute myocardial infarction patients without reperfusion therapy for recurrence of cardiovascular events within 1 year].

Objective: To assess whether acute-phase plasma PCSK9 levels predict recurrent cardiovascular (CV) events in acute myocardial infarction (AMI) patients without receiving reperfusion therapy. Methods: Plasma PCSK9 levels were measured during the acute phase (≤24 hours) in 882 patients who did not undergo reperfusion therapy from the China PEACE-Prospective AMI Study (2012-2014). Associations of acute-phase PCSK9 tertiles with patient characteristics and recurrent CV events at 1 year were assessed using multivariable logistic and Cox proportional hazards regression models. Results: Female gender (odds ratio [OR] 2.86, 95% confidence interval [CI] 1.36-5.98), premature coronary heart disease (CHD) (OR 2.82, 95%CI 1.43-5.53), higher high-sensitivity C-reactive protein (OR 1.69, 95%CI 1.35-2.13), and higher triglycerides (OR 1.93, 95%CI 1.10-3.38) were associated with higher baseline PCSK9 levels. Patients with PCSK9 levels in the highest tertile (versus lowest) did not have an increased risk of 1-year recurrent CV events (HR 0.77, 95%CI 0.44-1.34). Conclusion: Acute-phase plasma PCSK9 levels are associated with levels of inflammation and triglycerides, premature CHD, and gender in AMI patients without reperfusion therapy, however it do not predict recurrent CV events at 1 year.目的： 评估未接受再灌注治疗的急性心肌梗死（AMI）患者急性期血浆前蛋白转化酶枯草杆菌蛋白酶9（PCSK9）水平是否可以预测再发心血管事件。 方法： 882例研究样本选自China PEACE-Prospective AMI（2012-2014年）研究队列中心肌梗死后未行再灌注治疗的患者血浆样本，测量急性期PCSK9水平。采用Cox比例风险回归模型评估急性期不同水平PCSK9分组患者的临床特征与1年再发心血管事件的相关性。 结果： 女性（OR 2.86，95%CI 1.36~5.98），早发冠心病（OR 2.82，95%CI 1.43~5.53），高水平的Hs-CRP（OR 1.69，95%CI 1.35~2.13）和三酰甘油（OR 1.93，95%CI 1.10~3.38）与高水平的急性期PCSK9相关。高水平PCSK9组（PCSK9>66%分位点）相比于低水平PCSK9组（PCSK9<33%分位点）患者1年内再发心血管事件的风险没有增加（HR 0.77，95%CI 0.44~1.34）。 结论： 未行再灌注治疗的AMI患者中，急性期血浆PCSK9水平与炎症、三酰甘油、早发冠心病和性别相关，但急性期血浆PCSK9水平不能预测1年后再发心血管事件。.