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Updated: Mar 7, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Association between plasma proprotein convertase subtisilin/kexin type 9 concentration and coronary artery
Xi Zhao1, Hui-Wen Zhang1, Sha Li1
1Division of Dyslipidaemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Insights
Plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) is positively associated with coronary artery calcification (CAC) in patients with chest pain. Higher PCSK9 levels correlate with increased CAC, suggesting PCSK9 may be a biomarker for coronary artery disease progression.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Medical Diagnostics
Background:
- Plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) is implicated in cardiovascular risk factors and diseases.
- Existing research suggests a link between PCSK9, inflammatory markers, and coronary artery disease (CAD).
Purpose of the Study:
- To investigate the association between plasma PCSK9 concentrations and coronary artery calcification (CAC).
Main Methods:
- A cohort of 403 untreated patients with angina-like chest pain underwent electron beam computed tomography.
- Coronary artery calcification score (CACS) was measured, and plasma PCSK9 levels were determined using ELISA.
- Statistical analyses, including multivariable linear regression, were performed to assess the relationship between PCSK9 and CACS.
Main Results:
- Patients with detectable CAC (CACS > 0) exhibited significantly higher plasma PCSK9 concentrations compared to those without CAC (CACS = 0).
- A positive correlation was observed between higher PCSK9 levels and increased CACS.
- PCSK9 was independently associated with CAC after adjusting for traditional cardiovascular risk factors (P = 0.002).
- Plasma PCSK9 concentration demonstrated predictive value for CAC with an AUC of 0.736.
Conclusions:
- A significant positive association exists between plasma PCSK9 concentration and CAC in untreated patients presenting with angina-like chest pain.
- PCSK9 may serve as a potential biomarker for coronary artery calcification.
- Further research is warranted to confirm these findings and elucidate the clinical implications of PCSK9 in cardiovascular disease.
Abstract:
Background Plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) has been reported to be related to several risk factors and diseases such as inflammatory markers and coronary artery disease. The aim of present study was to investigate whether plasma PCSK9 concentration was associated with coronary artery calcification. Methods A total of 403 consecutive untreated patients with angina-like chest pain, who received electron beam computed tomography, were enrolled and a coronary artery calcification score (CACS) was also measured. The baseline clinical characteristics were collected and blood sample was taken after 12-h fasting. The plasma PCSK9 concentrations were determined by ELISA in all patients, and the relationship between plasma PCSK9 concentrations and CACS was investigated. Results Patients with coronary artery calcification (CACS > 0) had significant higher plasma PCSK9 concentrations compared with those (CACS = 0) without coronary artery calcification (258.58 ± 69.53 ng/mL vs. 202.53 ± 52.17 ng/mL, P < 0.001). Patients with highest PCSK9 concentrations had the highest CACS. Multivariable linear regression analysis suggested that PCSK9 was independently associated with coronary artery calcification ( P = 0.002) after adjusting for traditional cardiovascular risk factors. Furthermore, the area under the curve for the plasma PCSK9 concentration in predicting coronary artery calcification was 0.736 (95% CI: 0.687-0.785, P < 0.001), with a sensitivity of 66% and specificity of 70%. Conclusion A positive association between plasma PCSK9 concentration and coronary artery calcification in untreated patients with angina-like chest pain was observed in our study, suggesting that further investigation may be needed in order to confirm our primary findings and explore the clinical implications.
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