Elevation of lipoprotein(a) and PCSK9 serum plasma concentration among patients with angiogram-proven premature coronary artery disease in an Asian Cohort

Coronary artery disease (CAD) has been associated with elevated Lp(a) levels, yet the underlying mechanism by which Lp(a) mediates atherogenesis and inflammation is still incompletely understood. Proprotein convertase subtilisin/kexin type 9 (PCSK9) known to be during the inflammatory process, thus a potential relationship between Lp(a) and PCSK9 could be established. This study aimed to investigate the correlation and association between Lp (a) and PCSK9 in the angioproven-premature CAD (AP-pCAD) subjects with and without FH. Patients were recruited from Cardiology and Specialist Lipid Clinics were grouped into + pCAD + FH (n = 70), +pCAD -FH (n = 65), and -CAD-FH (G3; n = 69). FH was clinically diagnosed using Dutch Lipid Clinic Network Criteria. Lp(a) and PCSK9 levels were measured using an automated chemistry analyser and ELISA, respectively. Both were higher in + pCAD + FH [27.2 (13.2–72.2), 431.4 (178.0-1008.0)] and + pCAD -FH [34.7 (12.7-100.9), 471.4 (333.1–1188.0] compared to G3 [7.5 (7.0-14.7), 389.7 (147.1-566.2)]. In conclusion, Lp(a) and PCSK9 levels were significantly higher in pCAD compared to G3-normal control (NC) group, regardless the FH clinical diagnosis. A significant correlation was found in all pCAD and NC groups. We suggested that PCSK9 concentration is correlated with Lp(a) levels in pCAD and NC groups, indicating its potential of becoming a CAD predictor.