Decreased serum PCSK9 levels after ischaemic stroke predict worse outcomes. (10th November 2016)

• Record Type: Journal Article
• Authors: Liberale, Luca; Montecucco, Fabrizio; Casetta, Ilaria; Seraceni, Silva; Trentini, Alessandro; Padroni, Marina; Dallegri, Franco; Mach, François; Fainardi, Enrico; Carbone, Federico
• Is Part Of: European journal of clinical investigation. Volume 46:Number 12(2016:Dec.)
• Page Start: 1053
• Page End: 1062
• Publication Date: 2016-11-10
• Subjects: Cholesterol -- injury -- ischaemic stroke -- PCSK9; Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.12692
• Languages: English
• ISSNs: 0014-2972

Abstract

Abstract: Background: Soluble mediators have been investigated to predict the prognosis of acute ischaemic stroke (AIS). Among them, proprotein convertase subtilisin/kexin type 9 (PCSK9) might have both clinical and pathophysiological relevance. Materials and methods: All available serum samples from a cohort of patients with first AIS ( n = 72) were tested for PCSK9 and included in this substudy analysis. The primary endpoint investigated the predictive value of early PCSK9 level variations (ΔPCSK9) from AIS onset to day 7 or from day 1 to day 7, towards a 90‐day outcome by modified Rankin Scale (mRS). The secondary endpoint explored the association between ΔPCSK9 and the risk of major adverse cardiovascular events (MACEs). Results: Decreased serum PCSK9 levels at days 1 and 7 were associated with poor clinical outcomes at day 90. At the cut‐off point identified by ROC curve analysis (−61·28 ng/mL), ΔPCSK9 day 7–day 1 predicted a poor mRS at day 90 after AIS. ΔPCSK9 day 7–day 1 ≤ −61·28 ng/mL was associated with an increased rate of MACEs. Conclusion: A decrease in PCSK9 levels was a predictor for poor outcome and increased MACEs after AIS. Additional studies targeting post‐AIS PCSK9 levels and activity are required to clarify the prognostic and pathophysiological relevance of PCSK9 after AIS.