Abstract 20427: A Higher Levels Of Pcsk9 is Associated With Coronary Spotty Calcification in Patients With Acute Coronary Syndromes
Background: Proprotein convertase subtilisin kexin type 9 (PCSK9) is recognized as a key target in the treatment of hypercholesterolemia, but its clinical utility in the management of acute coronary syndromes (ACS) remains unclear. Therefore, we investigated the association between serum PCSK9 levels and the coronary atherosclerotic plaque with ACS, as assessed by integrated backscatter intravascular ultrasound (IB-IVUS).
Methods: We enrolled 28 patients with ACS who underwent successful primary percutaneous coronary intervention. The baseline characteristics were collected and the serum PCSK9 levels was determined by ELISA. The cross-sectional vessel area and plaque area were measured in the culprit lesions and proximal segment in target vessels by serial IVUS.
Results: Median PCSK9 level was 334.5 μg/L and ranged from 195 to 577 μg/L. Based on this cut-off points, patients divided into 2 groups; the higher PSCK9 levels (> 334.5μg/L) and the lower PCSK9 levels (≤ 334.5μg/L). In culprit lesions, calcified tissue area was significantly larger in higher group (0.06 mm2 vs 0.14mm2, p=0.02), whereas plaque area (lower vs higher: 8.47mm2 vs 8.36mm2, p=0.91) and all tissue fraction were no significant differences. In proximal segment in target vessels, %plaque area (33.8% vs 42.8%, p=0.03) and fibrous tissue area (1.86 mm2 vs 2.79mm2, p=0.02) was significantly larger in higher group, but other tissue fraction were no differences.
Conclusion: The presence of spotty calcification in culprit lesion has been implicated in plaque vulnerability. As one of mechanisms of ACS, the higher levels of PCSK9 may be associated with an inducing of plaque progression and vulnerability.
Author Disclosures: M. Watanabe: None. F. Hayashi: None. M. Tokue: None. R. Iijima: None. H. Hara: None. M. Moroi: None. M. Nakamura: None.
- © 2016 by American Heart Association, Inc.