Association between circulating proprotein convertase subtilisin/kexin type 9 levels and prognosis in patients with severe chronic kidney disease. Issue 4 (22nd August 2018)

• Record Type: Journal Article
• Authors: Rasmussen, Laust Dupont; Bøttcher, Morten; Ivarsen, Per; Jørgensen, Hanne Skou; Nyegaard, Mette; Buttenschøn, Henriette; Gustafsen, Camilla; Glerup, Simon; Bøtker, Hans Erik; Svensson, My; Winther, Simon
• Is Part Of: Nephrology dialysis transplantation. Volume 35:Issue 4(2020)
• Page Start: 632
• Page End: 639
• Publication Date: 2018-08-22
• Subjects: coronary artery disease -- kidney transplant candidates -- low-density lipoprotein cholesterol -- major adverse cardiac events -- PCSK9; Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfy257
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: Background: Chronic kidney disease is a risk factor for premature development of coronary atherosclerosis and mortality. A high level of proprotein convertase subtilisin/kexin type 9 (PCSK9) is a recently recognized cardiovascular risk factor and has become the target of effective inhibitory treatment. In 167 kidney transplantation candidates, we aimed to: (i) compare levels of PCSK9 with those of healthy controls, (ii) examine the association between levels of PCSK9 and low-density lipoprotein cholesterol (LDL-c) and the degree of coronary artery disease (CAD) and (iii) evaluate if levels of PCSK9 predict major adverse cardiac events (MACE) and mortality. Methods: Kidney transplant candidates ( n = 167) underwent coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA) before transplantation. MACE and mortality data were extracted from the Western Denmark Heart Registry, a review of patient records and patient interviews. A group of 79 healthy subjects were used as controls. Results: Mean PCSK9 levels did not differ between healthy controls and kidney transplant candidates. In patients not receiving lipid-lowering therapy, PCSK9 correlated positively with LDL-c (rho = 0.24, P < 0.05). Mean PCSK9 was similar in patients with and without obstructive CAD at both CCTA and ICA. In a multiple regression analysis, PCSK9 was associated with neither LDL-c ( β =−6.45, P = 0.44) nor coronary artery calcium score ( β =2.17, P = 0.84). During a follow-up of 3.7 years, PCSK9 levels were not associated with either MACE or mortality. Conclusions: The ability of PCSK9 levels to predict cardiovascular disease and prognosis does not seem to apply to a cohort of kidney transplant candidates.