Circulating PCSK9 as a prognostic biomarker of cardiovascular events in individuals with type 2 diabetes: evidence from a 16.8-year follow-up study
Authors' conclusion
Considering that up to two-thirds of individuals with T2DM develop ASCVD in their lifetime, the assessment of circulating PCSK9 levels can be envisioned within the context of a biomarker-based strategy of risk stratification. However, the sex difference found highlights an urgent need to develop sex-specific risk assessment strategies.
Study context
- Population
- Caucasian patients with T2D followed for a median of 16.8 years
- Participants
- 529 patients
- Exposure
- Serum PCSK9 levels as predictor of major adverse cardiovascular events (MACE) and all-cause mortality
- Outcome
- MACE and all-cause mortality predicted by fasting serum PCSK9
- Follow-up
- Median 16.8 years
Main finding
As reported in the abstract
Serum PCSK9 predicted new-onset MACE only in women, OR
2.26 (1.12-4.58) (95% CI)
Serum PCSK9 predicted all-cause mortality only in men, HR
1.79 (1.13-2.82) (95% CI)
Observational data: associations, not effects.
Further findings
PCSK9 levels
- Median PCSK9 level
- 259.8 ng/mL
- Higher in women than men, higher still with a complication (e.g., DKD)
Correlates of PCSK9
- Positive correlation with glucose homeostasis markers (HbA1c, fasting insulin, HOMA-IR) and atherogenic lipid profile (non-HDL-C, apoB, remnant cholesterol)
Original publication
Circulating PCSK9 as a prognostic biomarker of cardiovascular events in individuals with type 2 diabetes: evidence from a 16.8-year follow-up study. Cardiovasc Diabetol. Published 24 August 2023. doi:10.
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