Analysis of Influencing Factors of Plasma Proprotein Convertase Subtilisin/Kexin Type 9 in Patients with Acute Myocardial Infarction

Background Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a crucial role in lipid metabolism. The factors influencing PCSK9 in acute myocardial infarction (AMI) patients have not been fully understood. Objective To investigate the influence factors of PCSK9 among AMI patients. Methods Patients with an admission diagnosis of AMI between 2010 and 2018 were consecutively enrolled in the Department of Cardiology, Peking University First Hospital. Baseline information was collected from patients' current history, past history, and physical examination in the electronic medical record system at admission, and baseline plasma PCSK9 levels were measured. The related factors of PCSK9 were analyzed using univariate and multivariate linear regressions. The LASSO method was employed, the selected variables were subsequently included in the analysis of a multivariate linear regression model. Results 996 AMI patients were consecutively enrolled from 2010 to 2018, and 37 patients with no PCSK9 measurement results due to insufficient volume of retained blood samples were excluded. A total of 959 patients were included in the analysis. The median PCSK9 levels were 543.1 (425.4, 692.1) ng/mL. The multivariate linear regression analysis of non-genetic factors of PCSK9 showed that gender had the greatest effect (standardized regression coefficient was 0.13). Other significant factors related to PCSK9 levels were history of atrial fibrillation (standardized regression coefficient was 0.09), white blood cell count (standardized regression coefficient was 0.07) and uric acid levels (standardized regression coefficient was 0.07) . Conclusion In patients with AMI, gender, history of atrial fibrillation, blood white blood cell count, and uric acid levels were significant independent factors related to plasma PCSK9 levels.