Lipoprotein(a) and proprotein convertase subtilisin/kexin type 9 levels in patients with acute myocardial infarction

Introduction: Lipoprotein (a) (Lp(a)) has atherogenic effects. Proprotein convertase subtilisin /keksin type 9 (PCSK9) involved in the degradation of LDL-C receptors, increasing LDL-C blood level. Hypothesis: Identify the relationship between Lp(a) and PCSK9 blood levels and major cardiovascular events (unstable angina, myocardial infarction, cardiovascular death) after acute myocardial infarction. Methods: The study included 119 patients with acute myocardial infarction (97 men and 22 women aged 50-70 years). Blood samples were taken on the 2nd day of myocardial infarction. The Lp(a) blood level was determined by immunoturbidimetry (RANDOX), the PCSK9 blood level was determined by ELISA (BioVendor). Primary combined endpoint included hospitalization due to myocardial infarction and unstable angina and cardiovascular death. Patient follow-up was 52 weeks. Statistical analysis methods included Mann-Whitney test and non-parametric correlation by Spearman. Results: In 36 (30.2%) patients with acute myocardial infarction the Lp(a) blood levels were higher than 30 mg/dL. In 83 (69.7%) patients the Lp(a) blood level were below 30 mg/dL. Mean values of Lp(a) blood level was 29.26 ± 2.79 (men 27.71 ± 2.82 mg/dL, women 36.07 ± 8.54 mg/dL, p = 0.797). Mean PCSK9 blood level was 479.7 ± 15.4 ng/ml (males 465.6 ± 16.2ng/ml, females 534.9 ± 38.9 ng/ml, p = 0.122). There was no significant correlation of Lp(a) blood level with total cholesterol, LDL-C, triglycerids and PCSK9 blood levels. No significant correlation was found between Lp(a) and PCSK9 blood levels and cardiovascular events within 12 months. In the group of smoking patients (n = 22) there was found negative correlation between PCSK9 and HDL-C blood levels (-0.45, p = 0.039). Conclusions: Due to the fact that there is no relationship between Lp(a) and PCSK9 blood levels and subsequent cardiovascular events within 52 weeks, the effectiveness of the use of PCSK9 inhibitors after acute myocardial infarction is doubtful.

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Effects of evolocumab on plasma levels of proprotein convertase subtilisin/kexin type 9 and lipoprotein(a) in acute myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.3333 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Nakamura ◽

M Kanazawa ◽

Y Kagaya ◽

M Kondo ◽

K Sato ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Plasma Levels ◽

Cardiovascular Events ◽

Area Under The Curve ◽

Proprotein Convertase ◽

Measurement Sensitivity ◽

Lipoprotein A ◽

Sensitivity Level ◽

Acute Mi

Abstract Background There are two types of circulating proprotein convertase subtilisin/kexin type 9 (PCSK9), mature and furin-cleaved. Most types of lipoprotein(a) [Lp(a)], an independent risk factor of cardiovascular events, bound to mature PCSK9. Purpose This study examined the effects of monoclonal anti-PCSK9 antibody on plasma PCSK9 and Lp(a) levels in acute myocardial infarction (MI). Methods Acute MI patients (n=36) were randomly divided into evolocumab (140 mg; n=17) and non-evolocumab (n=19) groups. Changes in plasma PCSK9 and Lp(a) levels were monitored before and 1, 3, 5, 10, and 20 days after evolocumab administration. Results In the non-evolocumab group, plasma levels of mature PCSK9, furin-cleaved PCSK9, and Lp(a) (236.4±57.3 ng/mL, 22.4±5.8 ng/mL, and 19.2. ± 16.5 mg/dL, respectively) significantly increased by day 3 (408.8±77.1 ng/mL, P<0.001; 47.2±15.7 ng/mL, P<0.001; and 39.7±21.3 mg/dL, P<0.005, respectively) and returned to the baseline by day 10 or 20. In the evolocumab group, mature PCSK9 significantly increased by >1000 ng/mL with a simultaneous decline of furin-cleaved PCSK9 below the measurement sensitivity level after day 3. The incremental area under the curve for plasma Lp(a) levels was significantly smaller in the evolocumab group compared with the non-evolocumab group (P=0.038). Conclusion Mature and furin-cleaved PCSK9 are transiently upregulated after MI onset. Evolocumab significantly increases mature PCSK9 and decreases furin-cleaved PCSK9 and might inhibit transient increase of plasma Lp(a) in acute MI. Figure 1 Funding Acknowledgement Type of funding source: None

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22. Joint effect of acute myocardial infarction on lipoprotein(a), C- reactive protein and markers of haemostasis

Journal of the Saudi Heart Association ◽

10.1016/j.jsha.2015.05.203 ◽

2015 ◽

Vol 27 (4) ◽

pp. 308

Author(s):

Syed Shahid Habib ◽

Abdul Jalil Mohammad Abdul Gader ◽

Mohammad Ibrahim Kurdi ◽

Zohair Al Aseri ◽

Mona Mohamed Soliman

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Joint Effect ◽

C Reactive Protein ◽

Lipoprotein A ◽

Reactive Protein

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Usefulness of Lipoprotein (a) for Predicting Progression of Non-Culprit Coronary Lesions After Acute Myocardial Infarction

Circulation Journal ◽

10.1253/circj.cj-11-0365 ◽

2011 ◽

Vol 75 (12) ◽

pp. 2847-2852 ◽

Cited By ~ 15

Author(s):

Hiroki Ikenaga ◽

Masaharu Ishihara ◽

Ichiro Inoue ◽

Takuji Kawagoe ◽

Yuji Shimatani ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Lipoprotein A ◽

Coronary Lesions

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Risk of Primary and Recurrent Acute Myocardial Infarction From Lipoprotein(a) in Men and Women11This study was supported by grants from the National Heart Foundation of Australia, National Health and Medical Research Council of Australia, Newcastle.

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(96)00238-0 ◽

1996 ◽

Vol 28 (4) ◽

pp. 870-875 ◽

Cited By ~ 15

Author(s):

SCOTT KINLAY ◽

ANNETTE J DOBSON ◽

RICHARD F HELLER ◽

PATRICK McELDUFF ◽

HILARY ALEXANDER ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Medical Research ◽

National Health ◽

Research Council ◽

Medical Research Council ◽

Lipoprotein A ◽

National Heart ◽

National Heart Foundation ◽

Heart Foundation

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Contribution of lipoprotein(a) to cardiovascular risk in patients under 40 years of age after acute myocardial infarction or acute cerebral circulation disorder

Clinical Medicine (Russian Journal) ◽

10.18821/0023-2149-2016-94-3-194-199 ◽

2016 ◽

Vol 94 (3) ◽

pp. 194-199 ◽

Cited By ~ 1

Author(s):

Viktoriya A. Korneva ◽

T. Yu. Kuznetsova ◽

A. S. Novitskaya ◽

A. N. Malygin ◽

T. A. Guseva ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiovascular Risk ◽

Arterial Hypertension ◽

Cerebral Circulation ◽

Age Groups ◽

Middle Aged ◽

Vascular Events ◽

Lipoprotein A ◽

Cerebral Circulation Disorders

Aim. To evaluate the importance of lipoprotein(a) for the evaluation of cardiovascular risk in patient under 40 years of age after acute myocardial infarction or acute cerebral circulation disorder. Materials and methods. We analysed the data from two departments of the Regional Vascular Centre for 2013-2015 including 90 case histories of patients of different age (mean 57.8±3.4 yr) and studied standard risk factors, such as age, sex, smoking habits, dyslipidemia, aggravated heredity, arterial hypertension (AH), obesity. Standard examination of 7 patients under 40 years of age was supplemented by measuring lipoprotein(a) by the immunoturbodimetric method regarding the levels over J. 3 g/l as abnormally elevated. Results. The study group was dominated by young and middle-aged men (85.2 and 84% respectively). The key riskfactors were increased LDLP level (88%) and smoking (70%) in patients under the age of 40 and AH in middle-aged men (100%, p<0.004). Arterial hypertension was also diagnosed in 59% of the younger subjects. Increased LDLP levels most frequently occurred in senior patients (90%). The group ofpatients under 40 yr included 15% of those having a single risk factor. In this group, 22% of the patients were at high risk calculated prior to the development of vascular events, 58% at moderate and 20% at low risk. 42.8% of the patients had elevated lipoprotein(a) levels. Conclusion. Based on the relative risk scoring scale, 22% of the patients under 40 years of age were at risk of myocardial infarction or cerebral circulation disorders prior to the development of vascular events. However, these patients like those of other age groups frequently had traditional riskfactors, such as smoking (67.5%), AH and dyslipidemia (66.6% each). Total cholesterol was elevated only in 47.6% of the patients while LDLP and LP(a) in 92 and 42.8% respectively.

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