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Abstract: FR-PO435

Circulating PCSK9 Level Predicts Risk of Cardiovascular Events and Death in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kang, Min hye, Kyung Hee University Hospital, Seoul, Korea (the Republic of)
  • Kim, Jin sug, Kyung Hee University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yang gyun, Kyung Hee University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, So-young, CHA Bundang Medical Center, CHA University, Seongnam, Korea (the Republic of)
  • Ahn, Shin-Young, Korea University Medical Center, Seoul, Korea (the Republic of)
  • Ko, Gang Jee, Korea University Guro Hospital, Seoul, Korea (the Republic of)
  • Lee, Hong Joo, Seoul Red Cross Hospital, Seoul, Korea (the Republic of)
  • Lee, Dong-Young, Veterans Health Service Medical Center, Seoul, Korea (the Republic of)
  • Jeong, Kyung hwan, Kyung Hee University Hospital, Seoul, Korea (the Republic of)
  • Hwang, Hyeon Seok, Kyung Hee University Hospital, Seoul, Korea (the Republic of)
Background

The proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising new target for prevention of cardiovascular event (CVE). However, the clinical significance of circulating PCSK9 is unclear in HD patients

Methods

A total of 353 patients were prospectively enrolled from June 2016 to May 2018 in K-cohort study groups. Serum PCSK9 level was measured at the time of study enrollment. Serum levels of high-sensitivity C-reactive peptide (hsCRP), monocyte chemoattractant protein (MCP)-1, interleukin (IL)-6, osteoprotegerin and receptor activator of nuclear factor kappa-Β ligand (RANKL) were also measured. The primary endpoint was defined as composite of CVE and death from any cause.

Results

Serum PCSK9 level was positively correlated with total cholesterol level, but not with inflammatory (hsCPR, MCP-1 and IL-6) and calcification-related markers (osteoprotegerin and RANKL). Multivariate linear regression analysis revealed that statin treatment, serum albumin and total cholesterol levels at baseline were independent determinants of circulating PCSK9 levels. In multivariate Cox-regression analysis, PCSK9 tertile 3 was associated with 1.99-fold risks for composite event (95% confidence interval [CI], 1.08-3.66), and it was independently associated with 2.26-fold risks for CVE (95% CI, 1.11-4.62). PCSK9 tertile 3 also provides additional prognostic significance to predict composite event in subgroups with higher level of hsCRP and LDL, and no statin treatment.

Conclusion

Circulating PCSK9 level independently predicts CVE and death in HD patients, and these results anticipate future studies for the effect of PCSK9 inhibition in HD patients.