摘要
Abstract
Objective To investigate the correlation between serum proprotein convertase subtilisin/kexin type 9(PCSK9)and the risk of coronary vulnerable plaque in patients with acute coronary syndrome(ACS).Methods A total of 130 ACS patients at the Fourth People's Hospital of Langfang City from March 2019 to March 2023 were selected as the research objects.Patients were divided into the vulnerable plaque group(VP group,59 cases)and non-vulnerable plaque group(non-VP group,71 cases)based on coronary computed tomography angiography(CCTA)findings,with the VP group having≥2 features of vulnerable plaques,and non-VP group not having≥2 features of vulnerable plaques.Clinical data and the serum expression level of PCSK9 were compared between the two groups.The correlation between PCSK9 and other clinical indicators in the VP group was analyzed.Influencing factors for the risk of vulnerable plaques were analyzed by binary Logistic regression.The predictive performance of PCSK9 was assessed by ROC curve.Results There were significant differences in fasting plasma glucose(FPG),high density lipoprotein cholesterol(HDL-C),triglyceride(TG),uric acid,creatinine,D-dimer(D-D),hypersensitive C-reactive protein(hs-CRP),nitric oxide synthase(NOS),PCSK9,and disease types between the two groups(P<0.05).Serum PCSK9 level in the VP group was significantly higher than that in the non-VP group(P<0.01).Correlation analysis showed that serum PCSK9 level was positively correlated with the levels of TG,uric acid,creatinine,D-D and hs-CRP in the VP group(r=0.305,0.193,0.131,0.129,0.137,0.439;all P<0.05)and negatively correlated with HDL-C and NOS levels(r=-0.368,-0.296;both P<0.05).Binary Logistic regression analysis showed that PCSK9 was an influencing factor for the occurrence of vulnerable plaques(OR=3.678,95%CI=2.564-23.160,P<0.01).ROC curve analysis revealed that the optimal cut-off value of PCSK9 for predicting vulnerable plaques in ACS patients was 92.17 μg/L,with a sensitivity of 84.75%and a specificity of 77.46%,and the area under ROC curve was 0.859(95%CI=0.816-0.897).Conclusion Elevated serum PCSK9 level in ACS patients is correlated with the presence of vulnerable plaques in coronary arteries,and PCSK9 level has certain predictive value for vulnerable plaque.关键词
前蛋白转化酶枯草溶菌素9/急性冠状动脉综合征/易损斑块/影响因素Key words
Proprotein convertase subtilisin/kexin type 9/Acute coronary syndrome/Vulnerable plaque/Influencing factors
