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
. 2021 Feb;21(1):101-107.
doi: 10.1007/s10238-020-00658-9. Epub 2020 Aug 31.

Plasma PCSK9 levels and sepsis severity: an early assessment in the emergency department

Francesca Innocenti  1 , Anna Maria Gori  2 , Betti Giusti  2 , Camilla Tozzi  3 , Chiara Donnini  3 , Federico Meo  3 , Irene Giacomelli  3 , Maria Luisa Ralli  3 , Alice Sereni  2 , Elena Sticchi  2 , Irene Tassinari  3 , Rossella Marcucci  2 , Riccardo Pini  3
Affiliations

Plasma PCSK9 levels and sepsis severity: an early assessment in the emergency department

Francesca Innocenti et al. Clin Exp Med. 2021 Feb.

Abstract

The aim of the study is to evaluate the prognostic value of early PCSK9 levels in non-intubated septic patients admitted to the emergency department. This report utilized a portion of the data collected in a prospective study, with the aim of identifying reliable biomarkers for an early sepsis diagnosis. In the period November 2011-December 2016, we enrolled 268 patients, admitted to our High-Dependency Unit from the emergency department with a diagnosis of sepsis. Study-related blood samplings were performed at ED-HDU admission (T0), after 6 h (T6) and 24 h (T24). The primary endpoint was in-hospital mortality rate. PCSK9 circulating levels were higher than the normal value (≤ 313 ng/mL): at T0 661 ± 405 ng/mL, at T6 687 ± 417 ng/mL, at T24 718 ± 430 ng/mL. We divided the study population based on T0 quartiles distribution (≤ 370, 370-600, 600-900 and > 900 ng/ml). At T0, patients with normal PCSK9 showed the highest mortality compared to those in higher quartiles (T0: 39%, 20%, 23% and 18%, p = 0.036). By T6, the mortality curve tended to become U-shaped, with the lowest mortality among patients in the intermediate subgroups and an adverse prognosis in the presence of normal or very high levels of PCSK9 (35%, 26%, 18% and 23%, p = 0.235). A Kaplan-Meier analysis showed an increased mortality in patients with T0 and T6 PCSK9 ≤ 313 ng/ml (T0: 55 vs. 80%, p = 0.001; T6: 62 vs. 78%, p = 0.034). In subgroups with increasing levels of PCSK9, we found the best prognosis in the intermediate subgroups and an increased mortality among patients with normal and high values.

Keywords: Lipid metabolism; Prognosis; Sepsis.

PubMed Disclaimer

References

    1. Genga KR, Shimada T, Boyd JH, Walley KR, Russell JA. The understanding and management of organism toxicity in septic shock. J Innate Immun. 2018. https://doi.org/10.1159/000487818 . - DOI - PubMed - PMC
    1. Lekkou A, Mouzaki A, Siagris D, Ravani I, Gogos CA. Serum lipid profile, cytokine production, and clinical outcome in patients with severe sepsis. J Crit Care. 2014;29(5):723–7. https://doi.org/10.1016/j.jcrc.2014.04.018 . - DOI - PubMed
    1. Momtazi AA, Banach M, Sahebkar A. PCSK9 inhibitors in sepsis: a new potential indication? Exp Opin Investig Drugs. 2017;26(2):137–9. https://doi.org/10.1080/13543784.2017.1272570 . - DOI
    1. Walley KR. Role of lipoproteins and proprotein convertase subtilisin/kexin type 9 in endotoxin clearance in sepsis. Curr Opin Crit Care. 2016;22(5):464–9. https://doi.org/10.1097/MCC.0000000000000351 . - DOI - PubMed
    1. Walley KR, Thain KR, Russell JA, et al. PCSK9 is a critical regulator of the innate immune response and septic shock outcome. Sci Transl Med. 2014. https://doi.org/10.1126/scitranslmed.3008782 . - DOI - PubMed - PMC

LinkOut - more resources