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Background Proprotein convertase subtilisin/kexin type 9 (PCSK9) has multiple roles in the development and progression of atherosclerosis. Recent studies have indicated an association of PCSK9 with thrombotic process. Purpose We aimed to examine whether there exists a relationship between plasma PCSK9 concentration and the most commonly coagulation parameters including prothrombin time (PT) and activated partial thromboplastin time (APTT). Methods A total of 2293 consecutive patients with angina-like chest pain who had no treatment of lipid-lowering drugs were enrolled in this study. The baseline clinical and laboratory data were collected. PT and APTT tests were performed. Circulating PCSK9 concentrations were determined by ELISA and classified into three subgroups according to their levels of PCSK9 tertiles. The relation of PCSK9 concentration to PT or APTT were analyzed. Results Firstly, we found that the patients with high PCSK9 levels trended to have lower PT and APTT (p&amp;lt;0.0001, p=0.003) according to results of PCSK9 tertiles. Then, pearson correlation analysis showed that log-transformed PCSK9 concentration was negatively correlated with PT (r=−0.194, p&amp;lt;0.0001) and was significantly but weakly related with APTT (r=−0.075, p&amp;lt;0.0001). The stepwise multivariable regression analysis revealed that PCSK9 was independently related with PT after adjusting traditional atherosclerotic risk factors and coagulation parameters (β=−0.137, p&amp;lt;0.0001; β=−0.121, p&amp;lt;0.0001, respectively). Conclusion Circulating PCSK9 concentration was independently negative associated with PT, suggesting a potential link between PCSK9 and PT that may be involved in atherogenesis and atherothrombosis. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences

Association of circulating proprotein convertase subtilisin/kexin type 9 concentration with prothrombin time in patients with chest pain