Correlation Of Plasma PCSK9 Level And Severity Of Coronary Artery Stenosis In Patients Of Coronary Heart Disease

Objective:In this study,we detected the plasma PCSK9 level and analyzed the correlation of PCSK9 with coronary artery stenosis in patients with coronary heart disease(CHD).The result of this study could provide theoretical foundation for the diagnosis and treatment in clinical practice.Methods: 75 patients were enrolled in our study.These patients were hospitalized in the First Affiliated Hospital of Guangxi Medical University and accepted coronary angiography examination From August to November 2019.Among thoses patients,38 patients diagnosed as CHD were set as CHD group(n=38).Meanwhile,37 patients diagnosed with non-coronary heart disease were set as the control group(n=37).Blood samples were taken from all patiens after fasting overnight.The index included blood fat examination,blood routine examination,Fibrinogen,FBG,Hb A1 c.Basic information included gender,age,smoking history,blood pressure,diabetes history,etc.The severity of coronary artery stenosis was determined by Gensini Score.Plasma PCSK9 levels were detected by ELISA.Results:1.The gender ratio,age,BMI,diabetes morbidity rate,blood pressure level,total cholesterol(TC),high-density lipoprotein(HDL-C),Apolipoprotein A1(apoA1),Apolipoprotein B(apoB),platelet(PLT),APTT,PT,fasting glucose,Hb A1 c are not statistically different between CHD group and control group(P > 0.05).There are statistical differences in smoking rate,hypertension morbidity rate,LDL-C,HCY,apoB,apoA1/apoB,WBC,MONO,FIB between CHD group and control group(P < 0.05).2.The average PCSK9 level in CHD group(59.53±26.25ng/ml)is significantly higher than control group(34.77±7.89ng/ml P<0.001).3.In CHD group,The Gensini score,TC,LDL-C and apoB are positively correlated with PCSK9 level.The value of apoA1/B is negatively correlated with PCSK9 level.There is no significant difference between PCSK9 level and WBC,MONO,apoA1,fasting blood glucose,Hb A1 c,FIB and HCY(P >0.05).4.There is a statistically significant correlation between Gensini score and apoB and HCY in CHD group(P<0.05),but no statistically significant correlation between Gensini score and LDL-C,WBC,MONO,apoA1/B and FIB(P >,0.05).5.PCSK9 level has diagnostic value in predicting CHD,and the area under the curve is(AUC=0.884,95%CI0.811-0.956,P<0.001).After the calculation of the Youden index,PCSK9 predicted that the best bound value of the CHD is 57.61 ng/ml,the sensitivity was 64.3%,and the specificity was 75.0%.6.PCSK9 level has diagnostic value in predicting high Gensini score,and the area under the curve is(AUC=0.711,95%CI 0.535-0.887,P=0.032).After the calculation of the Youden index,PCSK9 predicted that the best bound value of the high Gensini score is 57.61ng/ml,the sensitivity was 64.3%,and the specificity was 75.0%.Conclusion: plasma PCSK9 level is increased in patients with CHD and positively related with the severity of coronary artery stenosis,and has diagnostic value in patient with CHD.