国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Association of PCSK9 levels and genetic polymorphisms with stroke recurrence and functional outcome after acute ischemic stroke

第一作者：Weiqi Chen,Yicong Wang

通讯作者：Yongjun Wang

PCSK9; stroke

基本信息

2022-06-30

已发表文章

发表杂志：Annals of Translational Medicine

发表类型: Article

影响因子(IF): 3.616

PMID: PMC9358512 Pubmed原文链接 全文下载

主要研究背景及目的

Prorotein convertase subtilisin/kexin type 9 (PCSK9) is synthesized in hepatocyte endoplasmic reticulum and maintains lipid homeostasis. PCSK9 is synthesized by PCSK9 gene. The low density lipoprotein（LDL）level of patients with functional acquired PCSK9 gene increased significantly, while the LDL level of patients with functional deleted PCSK9 gene decreased. Low density lipoprotein (LDL) is an important risk factor for intracranial atherosclerotic ischemic stroke. Previous studies found that PCSK9 polymorphisms and high PCSK9 level and were associated the higher level of LDL-C, an increased risk of coronary artery diseases. However, few study investigated the association of PCSK9 polymorphisms, high PCSK9 level and the outcomes of ischemic stroke. This study aimed to investigate the association of PCSK9 polymorphisms, PCSK9 level and the outcomes of ischemic stroke. This will provide new ideas and targets for guiding individualized secondary prevention and treatment for patients with ischemic stroke.

方法

A total of 9,782 acute ischemic stroke patients registered in the China National Stroke Registry III were included in this prospective study. Circulating PCSK9 concentrations and 11 key single-nucleotide polymorphisms (SNPs) were examined. The clinical outcomes included stroke recurrence, death, and poor functional outcome at 12 months.

结论

The high level of PCSK9 was associated with decreased stroke recurrence at 12 months in ischemic stroke patients. There was no significant association between PCSK9 polymorphisms and acute ischemic stroke based on a Chinese registry.

主要结果

The median PCSK9 level was 361.28 ng/mL. After adjusting for confounders, patients in the highest quartile of circulating PCSK9 had a relatively lower risk of 12-month stroke recurrence (HR 0.80, 95% CI: 0.67–0.96). No significant relationship between PCSK9 level and death or poor functional outcome was found. No significant relationship between SNPs and stroke outcomes at 12 months was found.