| Title: |
Proprotein convertase subtilisin/kexin type 9 (PCSK9) and clinical outcomes in dialysis patients |
| Authors: |
Torino, Claudia; Carbone, Federico; Pizzini, Patrizia; Mezzatesta, Sabrina; D'Arrigo, Graziella; Gori, Mercedes; Liberale, Luca; Moriero, Margherita; Michelauz, Cristina; Frè, Federica; Isoppo, Simone; Gavoci, Aurora; La Rosa, Federica; Scuricini, Alessandro; Tirandi, Amedeo; Ramoni, Davide; Mallamaci, Francesca; Tripepi, Giovanni; Montecucco, Fabrizio; Zoccali, Carmine |
| Contributors: |
Torino, Claudia; Carbone, Federico; Pizzini, Patrizia; Mezzatesta, Sabrina; D'Arrigo, Graziella; Gori, Mercede; Liberale, Luca; Moriero, Margherita; Michelauz, Cristina; Frè, Federica; Isoppo, Simone; Gavoci, Aurora; La Rosa, Federica; Scuricini, Alessandro; Tirandi, Amedeo; Ramoni, Davide; Mallamaci, Francesca; Tripepi, Giovanni; Montecucco, Fabrizio; Zoccali, Carmine |
| Publication Year: |
2024 |
| Collection: |
Università degli Studi di Genova: CINECA IRIS |
| Subject Terms: |
ESKD; PCSK9; cardiovascular; clinical outcome; dialysis |
| Description: |
Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9), a factor accelerating the degradation of LDL receptors, was associated with a gender-dependent risk for cardiovascular (CV) events in the general population and with all-cause and CV mortality in two relatively small studies in black Africans and South Korean haemodialysis patients. The effect modification by gender was untested in these studies. Methods: The study enrolled 1188 dialysis patients from the Prospective Registry of The Working Group of Epidemiology of Dialysis Region Calabria (PROGREDIRE) cohort. PCSK9 was measured by colorimetric enzyme-linked immunosorbent assay. The primary outcomes were all-cause and CV mortality. Statistical analysis included Cox regression analysis and effect modification analysis. Results: During a median 2.9-year follow-up, out of 494 deaths, 278 were CV-related. In unadjusted analyses, PCSK9 levels correlated with increased all-cause (HRfor1ln unit increase: 1.23, 95% CI 1.06-1.43, p =.008) and CV mortality (HRfor1ln unit increase: 1.26, 95% CI 1.03-1.54, p =.03). After multivariate adjustment, these associations were no longer significant (all-cause mortality, HRfor 1 ln unit increase: 1.16, 95% CI .99-1.36, p =.07; CV mortality, HRfor1ln unit increase: 1.18, 95% CI .95-1.46, p =.14). However, in fully adjusted interaction analyses, a doubling in the risk of this outcome in women was registered (Women, HRfor1ln unit increase: 1.88, 95% CI 1.27-2.78, p =.002; Men, HRfor1ln unit increase: 1.07, 95% CI .83-1.38, p =.61; p for effect modification: .02). Conclusions: PCSK9 levels are unrelated to all-cause mortality in haemodialysis patients but, like in studies of the general population, independently of other risk factors, entail a doubling in the risk of CV events in women in this population. |
| Document Type: |
article in journal/newspaper |
| File Description: |
ELETTRONICO |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/38733147; info:eu-repo/semantics/altIdentifier/wos/WOS:001217833200001; firstpage:1; lastpage:9; numberofpages:9; journal:EUROPEAN JOURNAL OF CLINICAL INVESTIGATION; https://hdl.handle.net/11567/1176076 |
| DOI: |
10.1111/eci.14235 |
| Availability: |
https://hdl.handle.net/11567/1176076; https://doi.org/10.1111/eci.14235 |
| Rights: |
info:eu-repo/semantics/closedAccess |
| Accession Number: |
edsbas.E5D1B1A |
| Database: |
BASE |