Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Association of PCSK9 levels and genetic polymorphisms with stroke recurrence and functional outcome after acute ischemic stroke
First author：Weiqi Chen,Yicong Wang
Corresponding author：Yongjun Wang
essential_information
- Person in charge：Weiqi Chen,Yicong Wang
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20200095
- Published time：2022-06-30
2022-06-30
Published articles
Journal：Annals of Translational Medicine
Publication type: Article
IF(IF): 3.616
PMID: PMC9358512 Link To Pubmed Full text Download
Background And Purpose
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.
Method
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.
Conclusion
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.
Main results
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.