Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Controlled Clinical Trial
. 2021 Feb;289(2):179-192.
doi: 10.1111/joim.13150. Epub 2020 Jul 30.

PCSK9 is associated with mortality in patients with septic shock: data from the ALBIOS study

A Vecchié  1   2 , A Bonaventura  1   2 , J Meessen  3 , D Novelli  3 , S Minetti  1   4 , E Elia  1 , D Ferrara  1 , A M Ansaldo  1 , V Scaravilli  5 , S Villa  6 , L Ferla  7 , P Caironi  8 , R Latini  3 , F Carbone  1   4 , F Montecucco  4   9 ; ALBIOS Biomarkers Study Investigators
Collaborators, Affiliations
Free article
Controlled Clinical Trial

PCSK9 is associated with mortality in patients with septic shock: data from the ALBIOS study

A Vecchié et al. J Intern Med. 2021 Feb.
Free article

Abstract

Background: Pro-protein convertase subtilisin/kexin 9 (PCSK9) is a proenzyme primarily known to regulate low-density lipoprotein receptor re-uptake on hepatocytes. Whether PCSK9 can concurrently trigger inflammation or not remains unclear. Here, we investigated the potential association between circulating levels of PCSK9 and mortality in patients with severe sepsis or septic shock.

Methods: Plasma PCSK9 levels at days 1, 2 and 7 were measured in 958 patients with severe sepsis or septic shock previously enrolled in the Albumin Italian Outcome Sepsis (ALBIOS) trial. Correlations between levels of PCSK9 and pentraxin 3 (PTX3), a biomarker of disease severity, were evaluated with ranked Spearman's coefficients. Cox proportional hazards models were used to assess the association of PCSK9 levels at day 1 with 28- and 90-day mortality.

Results: Median plasma PCSK9 levels were 278 [182-452] ng mL-1 on day 1. PCSK9 correlated positively with PTX3 at the three time-points, and patients with septic shock within the first quartile of PCSK9 showed higher levels of PTX3. Similar mortality rates were observed in patients with severe sepsis across PCSK9 quartiles. Patients with septic shock with lower PCSK9 levels on day 1 (within the first quartile) showed the highest 28- and 90-day mortality rate as compared to other quartiles.

Conclusion: In our sub-analysis of the ALBIOS trial, we found that patients with septic shock presenting with lower plasma PCSK9 levels experienced higher mortality rate. Further studies are warranted to better evaluate the pathophysiological role of PCSK9 in sepsis.

Keywords: PCSK9; mortality; pentraxin 3; sepsis; septic shock.

PubMed Disclaimer

References

    1. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315: 801-10.
    1. Conway SR, Wong HR. Biomarker panels in critical care. Crit Care Clin 2020; 36: 89-104.
    1. Caironi P, Masson S, Mauri T, et al. Pentraxin 3 in patients with severe sepsis or shock: the ALBIOS trial. Eur J Clin Invest 2017; 47: 73-83.
    1. Carbone F, Bonaventura A, Vecchiè A, et al. Early osteopontin levels predict mortality in patients with septic shock. Eur J Internal Med 2020. https://doi.org/10.1016/j.ejim.2020.04.035.
    1. Green P, Theilla M, Singer P. Lipid metabolism in critical illness. Curr Opin Clin Nutr Metab Care 2016; 19: 111-5.

Publication types

LinkOut - more resources