Proprotein convertase subtilisin/kexin type 9 (PCSK9) and clinical outcomes in dialysis patients.
Eur J Clin Invest
; : e14235, 2024 May 11.
Article
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| MEDLINE
| ID: mdl-38733147
ABSTRACT
BACKGROUND:
Proprotein convertase subtilisin/kexin type 9 (PCSK9), a factor accelerating the degradation of LDL receptors, was associated with a gender-dependent risk for cardiovascular (CV) events in the general population and with all-cause and CV mortality in two relatively small studies in black Africans and South Korean haemodialysis patients. The effect modification by gender was untested in these studies.METHODS:
The study enrolled 1188 dialysis patients from the Prospective Registry of The Working Group of Epidemiology of Dialysis Region Calabria (PROGREDIRE) cohort. PCSK9 was measured by colorimetric enzyme-linked immunosorbent assay. The primary outcomes were all-cause and CV mortality. Statistical analysis included Cox regression analysis and effect modification analysis.RESULTS:
During a median 2.9-year follow-up, out of 494 deaths, 278 were CV-related. In unadjusted analyses, PCSK9 levels correlated with increased all-cause (HRfor1ln unit increase 1.23, 95% CI 1.06-1.43, p =.008) and CV mortality (HRfor1ln unit increase 1.26, 95% CI 1.03-1.54, p =.03). After multivariate adjustment, these associations were no longer significant (all-cause mortality, HRfor 1 ln unit increase 1.16, 95% CI .99-1.36, p =.07; CV mortality, HRfor1ln unit increase 1.18, 95% CI .95-1.46, p =.14). However, in fully adjusted interaction analyses, a doubling in the risk of this outcome in women was registered (Women, HRfor1ln unit increase 1.88, 95% CI 1.27-2.78, p =.002; Men, HRfor1ln unit increase 1.07, 95% CI .83-1.38, p =.61; p for effect modification .02).CONCLUSIONS:
PCSK9 levels are unrelated to all-cause mortality in haemodialysis patients but, like in studies of the general population, independently of other risk factors, entail a doubling in the risk of CV events in women in this population.
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MEDLINE
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En
Revista:
Eur J Clin Invest
Año:
2024
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Article