Elevated circulating PCSK9 level is associated with 28-day mortality in patients with sepsis: a prospective cohort study

BMC Emerg Med. 2023 Oct 31;23(1):127. doi: 10.1186/s12873-023-00896-6.

Abstract

Objectives: Pro-protein convertase subtilisin/kexin 9 (PCSK9) decreases the clearance of the pathogenic lipids, supporting the potential role of PCSK9 in the prognosis of sepsis.

Methods: In this prospective cohort study, patients with sepsis were consecutively recruited from 1 to 2020 to 30 September 2021 at the First People's Hospital of Huaihua, China. All the eligible patients were categorized into low-PCSK9 and high-PCSK9 groups, based on their PCSK9 levels at admission. Time-dependent receiver operating characteristic curves and Cox proportional hazards regression were used to evaluate the association between PCSK9 level and 28-day mortality of sepsis.

Results: Of the 203 enrolled patients, 56 (27.59%) died during the 28-day follow-up. The PCSK9 level was positively related to the C-reactive protein level. The cut-off point of PCSK9 levels for 28-day mortality risk was 370 ng/ml. Through comparison between high-PCSK9 (> 370 ng/ml) with low-PCSK9 (≤ 370 ng/ml) groups, the adjusted HR for mortality was 2.56 (95% CI: 1.25-5.23, p = 0.01).

Conclusions: The 28-day mortality of sepsis increased significantly as the baseline circulating PCSK9 level exceeded 370 ng/ml, indicating circulating PCSK9 levels may be a potential biomarker to predict the prognosis of sepsis.

Keywords: Mortality; PCSK9; Sepsis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Proprotein Convertase 9*
  • Prospective Studies
  • Sepsis*
  • Subtilisin

Substances

  • PCSK9 protein, human
  • Proprotein Convertase 9
  • Subtilisin