PCSK9 is associated with mortality in patients with septic shock: data from the ALBIOS study. (30th July 2020)

• Record Type: Journal Article
• Authors: Vecchié, A.; Bonaventura, A.; Meessen, J.; Novelli, D.; Minetti, S.; Elia, E.; Ferrara, D.; Ansaldo, A. M.; Scaravilli, V.; Villa, S.; Ferla, L.; Caironi, P.; Latini, R.; Carbone, F.; Montecucco, F.
• Other Names: Bruzzone Paola investigator.; Pagan Francesca investigator.; Russo Riccarda investigator.; Confalonieri Andrea investigator.; Abbruzzese Chiara investigator.; Vergnano Beatrice investigator.; Faenza Stefano investigator.; Siniscalchi Antonio investigator.; Pierucci Elisabetta investigator.; Noto Andrea investigator.; Pezzi Angelo investigator.; Spanu Paolo investigator.; Parrini Vieri investigator.; Oggioni Roberto investigator.; Pasetti Giovanni Stefano investigator.; Casadio Maria Cinzia investigator.; Buontempo Rosa investigator.; Carrer Sara investigator.; Piccoli Francesca investigator.; Rizzi Tatiana investigator.; Caricato Anselmo investigator.; La Sala Monica investigator.; Antonaci Alessandra investigator.; Fassini Paola investigator.; Paganini Silvia investigator.; Porta Virginia investigator.; Moise Gabriella investigator.; Marell Silvia investigator.; Furia Mirella investigator.; Urbano Maria Cristina investigator.; Carobbi Roberta investigator.; Poleni Simona investigator.; Kandil Hassan investigator.; Ballotta Andrea investigator.; Bettini Fabrizio investigator.; Sanseverino Manlio investigator.; Gatta Alessandro investigator.; Cecchini Francesca investigator.; Guatteri Luca investigator.; Ciceri Gabriella investigator.; Raimondi Ferdinando investigator.; Colombo Roberto investigator.; Ferraris Sandra investigator.; Borelli Massimo investigator.; Bellato Valentina investigator.; Cancellieri Franco investigator.; Senni Silvia investigator.; Sacchi Noemi investigator.; Ferri Paola investigator.; Moioli Gianpietro investigator.; Fedele Andrea investigator.; Molin Alexandra investigator.; Salati Giovanni investigator.; Salsi Pierpaolo investigator.; Brunori Emanuela investigator.; Elisei Daniele investigator.; Maggio Giuseppe investigator.; Nicola Federico Guardia investigator.; Cavana Marco investigator.; Morelli Giacomo investigator.; Guarino Arturo investigator.; Isetta Michele investigator.; Tulli Giorgio investigator.; Mangani Valerio investigator.; Rossi Nicola investigator.; Ferrari Marta investigator.; Bona Francesco investigator.; Vay Monica investigator.; Bartoli Teresa investigator.; Gallo Mauro investigator.; Morte Mauro Della investigator.; Boselli Enrico investigator.; Puscio Daniela investigator.; Galzerano Antonio investigator.; Carli Manuela investigator.; Zagara Giovanni investigator.;
• Is Part Of: Journal of internal medicine. Volume 289:Number 2(2021)
• Page Start: 179
• Page End: 192
• Publication Date: 2020-07-30
• Subjects: mortality -- PCSK9 -- pentraxin 3 -- sepsis -- septic shock; Internal medicine -- Periodicals; Medicine -- Periodicals; 616
• DOI: 10.1111/joim.13150
• Languages: English
• ISSNs: 0954-6820

Abstract

Abstract: Background: Pro‐protein convertase subtilisin/kexin 9 (PCSK9) is a proenzyme primarily known to regulate low‐density lipoprotein receptor re‐uptake on hepatocytes. Whether PCSK9 can concurrently trigger inflammation or not remains unclear. Here, we investigated the potential association between circulating levels of PCSK9 and mortality in patients with severe sepsis or septic shock. Methods: Plasma PCSK9 levels at days 1, 2 and 7 were measured in 958 patients with severe sepsis or septic shock previously enrolled in the Albumin Italian Outcome Sepsis (ALBIOS) trial. Correlations between levels of PCSK9 and pentraxin 3 (PTX3), a biomarker of disease severity, were evaluated with ranked Spearman's coefficients. Cox proportional hazards models were used to assess the association of PCSK9 levels at day 1 with 28‐ and 90‐day mortality. Results: Median plasma PCSK9 levels were 278 [182–452] ng mL −1 on day 1. PCSK9 correlated positively with PTX3 at the three time‐points, and patients with septic shock within the first quartile of PCSK9 showed higher levels of PTX3. Similar mortality rates were observed in patients with severe sepsis across PCSK9 quartiles. Patients with septic shock with lower PCSK9 levels on day 1 (within the first quartile) showed the highest 28‐ and 90‐day mortality rate as compared to other quartiles. Conclusion: In our sub‐analysis of the ALBIOS trial, we found that patients with septic shock presenting with lower plasma PCSK9 levels experienced higher mortality rate. Further studies are warranted to better evaluate the pathophysiological role of PCSK9 in sepsis. Abstract :