Circulating levels of PCSK9 and arterial stiffness in a large population sample: Data from the brisighella heart study

Aim:Proprotein convertase subtilisin kexin type 9 (PCKS9) circulating levels are significantly associated with increased risk of total cardiovas-cular events. Risk markers for cardiovascular diseases (CVD) include pa-rameters relative to arterial structure and function. Our study aimed toevaluate the relationship between circulating levels of PCSK9 and arterial stiffness in a large sample of overall healthy subjects.Methods:From the historical cohort of the Brisighella Heart Study, four subgroups were selected; pre-menopausal women (n¼227), age-matchedmen (n¼193), post-menopausal women (n¼460) and age-matched men(n¼416). In these subjects, the correlation between PCSK9 plasma circulating levels and the pulse wave velocity (PWV) was evaluated. Active smokers, participants in secondary prevention for CVD treated with statins or vasodilating agents, were excluded from the analysis.Results:Post-menopausal women showed higher PCSK9 levels (309.9±84.1 ng/mL) compared to he other groups of subjects (p<0.001). Elderly men had significant higher levels than adult men (283.2±75.6 ng/mL vs.260.9± 80.4 ng/mL; p¼0.008) (Figure 1). PWV was mainly predicted by age (B¼0.116, 95%CI 0.96e0.127, p<0.001), PCSK9 (B¼0.014, 5%CI 0.011-0.016, p<0.001), and serum uric acid (B¼0.313, 05%CI 0.024-0.391, p¼0.026). Physical activity, low-density poprotein cholesterol, high-density lipoprotein cholesterol, and estimated glomerular filtration rate were not associated to the PWV level (p>0.05). Considering the above describedsubgroups, age and PCSK9 resulted the main factors associated to PWV; thelatter correlates to serum uric acid only in post-menopausal women.Conclusions:In the Brisighella Heart Study cohort, circulating PCSK9 aresignificantly related to the arterial stiffness, independently from gender and menopausal status.