Correlation Between PCSK9 Level And Severity Of Coronary Artery Stenosis In Acute Coronary Syndrome

Objective:To investigate the level of proprotein convertase subtilisin /kexin type 9(PCSK9)in patients with acute coronary syndrome(ACS)and its correlation with the severity of coronary artery stenosis.Methods:A total of 80 patients who were admitted to the Department of Cardiology of the Second Hospital of Shanxi Medical University from January 2019 to July 2019 and diagnosed with acute coronary syndrome by coronary angiography were selected as the ACS group.Another 50 patients who were hospitalized during the same period and had negative coronary angiography were selected as the control group.Gensini score was used to evaluate the degree of coronary stenosis in ACS patients.According to the Gensini score,ACS disease components were mild stenosis group(Gensini score 1-25 points,n = 26),moderate stenosis group(Gensini score 26-50 points),n= 27)and severe stenosis group(Gensini score ?51 points,n = 27).Collecting clinical data,taking venous blood before coronary angiography and sending to laboratory to measure high-sensitivity C-reactive protein(hs-CRP),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),fasting blood glucose(FBG),lipoprotein a(Lp(a)).Serum PCSK9 levels?serum interleukin-6(IL-6)levels were detected by enzyme-linked immunosorbent assay(ELISA).Comparing the difference of basic data and the serum PCSK9 level between ACS group and control group.Pearson correlation analysis was used to explore the correlation between serum PCSK9 and lipid index,inflammation index and Gensini score in ACS group.PCSK9 levels were compared among three subgroups in the ACS group by one-way analysis of variance.Results:1.Compared with the control group,the prevalence of diabetes,smoking rate,FBG,TC,LDL-C,Lp(a)?ApoB,hs-CRP,and IL-6 in the ACS group were significantly increased,and the differences were statistically significant(P <0.05).There was no significant difference in age,gender,BMI,prevalence of hypertension,TG,HDL-C,and ApoA1 levels between the two groups(P <0.05).2.Serum PCSK9 levels in ACS patients were positively correlated with TC,LDL-C,Lp(a)?ApoB,hs-CRP,and IL-6,and had no statistically significant correlation with TG,FBG,HDL-C,and ApoA1.3.Compared with the control group,the serum PCSK9 level in the ACS group was significantly increased,and the difference was statistically significant(P <0.05).4.Comparing serum PCSK9 levels be among ACS subgroups,severe stenosis group> moderate stenosis group> mild stenosis group,the difference was statistically significant(P< 0.05).5.Serum PCSK9 level was positively correlated with Gensini score in ACS patients(P< 0.05).Conclusion:PCSK9 promotes the occurrence and development of ACS by regulating lipid metabolism,participating in inflammatory responses in the body,and closely related to risk factors in the ACS group.As a simple clinical serum index,it has a good assessment and diagnostic value for coronary stenosis in patients with ACS.