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Review
. 2016 Nov 30;1(7):568-575.
doi: 10.1016/j.jacbts.2016.06.007. eCollection 2016 Dec.

Circulating PCSK9 and Risk of Myocardial Infarction: The HUNT Study in Norway

Lars E Laugsand  1   2 , Bjørn O Åsvold  1   3 , Lars J Vatten  1 , Imre Janszky  1   4 , Carl G Platou  1   5 , Annika E Michelsen  6 , Jan K Damås  7   8   9 , Pål Aukrust  6   10   11   12   13 , Thor Ueland  6   13
Affiliations
Review

Circulating PCSK9 and Risk of Myocardial Infarction: The HUNT Study in Norway

Lars E Laugsand et al. JACC Basic Transl Sci. .

Abstract

The usefulness of circulating proprotein convertase subtilisin-kexin type 9 (PCSK9) as a risk marker of coronary heart disease in the general population remains unclear. In a nested case-control study in Norway, 1,488 incident myocardial infarctions were registered during 11.3 years of follow-up and compared with 3,819 controls. Compared with participants in the lowest quartile of PCSK9, myocardial infarction risk was 47% higher in the highest quartile after adjustment for age and sex. After additional adjustment for low-density lipoprotein cholesterol, the association was strongly attenuated. Thus, circulating PCSK9 does not contribute useful information in the assessment of myocardial infarction risk in the general population beyond the information provided by lipid measurements.

Keywords: BMI, body mass index; CI, confidence interval; CRP, C-reactive protein; CVD, cardiovascular disease; HDL-C, high-density lipoprotein cholesterol; LDL, low-density lipoprotein; LDL-C, LDL cholesterol; MI, myocardial infarction; OR, odds ratio; PCSK9 inflammation; PCSK9, proprotein convertase subtilisin-kexin type 9; epidemiology; hsCRP, high-sensitivity C-reactive protein; myocardial infarction; prospective study; risk factors.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Sex- and Age- and Multi-Adjusted* Association Between Serum PCSK9 Concentrations (Expressed as a Restricted Cubic Spline) and Risk of Incident MI (ORs; 95% CI) (A) Sex- and age-adjusted; (B) multi-adjusted. *Adjusted for age, sex, diabetes mellitus, LDL-C, BMI, smoking, systolic blood pressure, diastolic blood pressure, triglycerides, HDL-C, log-transformed creatinine, and log-transformed C-reactive protein. †ORs with 95% CIs are displayed at the 2.5, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95 and 97.5 percentiles of PCSK9, based on the quantile distribution among controls and using the 5th percentile as the reference level. BMI = body mass index; CI = confidence interval; HDL-C = high-density lipoprotein cholesterol; LDL-C = low-density lipoprotein cholesterol; MI = myocardial infarction; OR = odds ratio; PCSK9 = proprotein convertase subtilisin-kexin type 9.
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