# Hoge PCSK9-waarden voorspellen cardiovasculair risico bij vrouwen — prospectief cohort

*geplaatst 2026-10-12 · Cholesterol · American journal of preventive cardiology · doi 10.1016/j.ajpc.2026.101785 · https://hartvaat.nl/2026/12/01/hoge-pcsk9-waarden-voorspellen-cardiovasculair-risico-bij-vrouwen-prospectief-co/*

In een prospectief cohort van 1876 cardiovasculair gezonde volwassenen volgden onderzoekers PCSK9-niveaus en CVD-incidentie op gedurende een mediane periode van 6,7 jaar. Hogere basale PCSK9-waarden waren geassocieerd met een lager CVD-risico bij mannen (HR 0,71), maar met een significant verhoogd risico bij vrouwen (HR 1,38; P=0,032 voor log-PCSK9). Deze geslachtsspecifieke associatie suggereert dat PCSK9 potentieel als biomarker kan dienen voor risicostratificatie bij vrouwen in de primaire preventie, hoewel klinische toepassing nog verder onderbouwd moet worden.

## English: Circulating PCSK9 as a sex-stratified predictor in primary prevention of cardiovascular disease: Insights from a prospective cohort study in Chinese adults.

In a prospective cohort of 1,876 cardiovascularly healthy adults, researchers tracked baseline serum PCSK9 levels and incident CVD over a median 6.7-year follow-up. Higher baseline PCSK9 was associated with a lower CVD risk in men (HR 0.71) but a significantly higher risk in women (HR 1.38; P=0.032), with marked sex-specific heterogeneity. These findings suggest PCSK9 could serve as a sex-stratified biomarker for primary prevention risk assessment, though its routine clinical utility requires further validation.

## Abstract (original, from the publication)

BACKGROUND: While proprotein convertase subtilisin/kexin type 9 (PCSK9) has emerged as an effective therapeutic target in secondary prevention of cardiovascular disease (CVD), its role in primary prevention remains unclear. Therefore, we examined the prospective association between PCSK9 and CVD risks in the general population. METHODS: In the Gusu cohort, 1876 community members (mean age 57 years, 38% males) who were free of CVD in 2014 were included. Serum PCSK9 was measured by enzyme-linked immunosorbent assay kits at baseline and CVD events were followed every 2 years through 2020. Associations between PCSK9 and CVD were examined using a Cox regression model in males and females, respectively. RESULTS: During a median follow-up of 6.7 years, 93 participants developed incident CVD. A higher level of serum PCSK9 at baseline was associated with a lower risk of CVD in males (HR=0.71, 95%CI: 0.52-0.96, P = 0.027 for log-PCSK9), but with a higher risk of CVD in females (HR=1.38, 95%CI: 1.03-1.84, P = 0.032 for log-PCSK9), independently of conventional risk factors. There was a significant heterogeneity between these two sex-specific associations (P = 0.002). Compared with participants with the lowest level of serum PCSK9, those with the highest level had a similar risk of CVD in males (HR=0.57, 95% CI: 0.27-1.20, P = 0.138), but a significantly increased risk in females (HR=2.78, 95%CI: 1.33-5.82, P = 0.006). Hypertension, dyslipidemia, and diabetes did not deliver a significant mediation effect on the association between serum PCSK9 and CVD (all P > 0.05). CONCLUSIONS: A higher serum PCSK9 at baseline predicted a higher future risk of CVD in the general female population. PCSK9 may be a candidate circulating biomarker for the risk of CVD in females. LAY SUMMARY: Leveraging a prospective cohort study including 1876 community members, this article examined for the first time the association between serum PCSK9 at baseline and the incidence of CVD during a median 6-year follow-up. A higher serum PCSK9 at baseline predicted a higher future risk of CVD in the general female population. Our findings suggest that PCSK9 may be a candidate circulating biomarker for the risk of CVD in females.

Auteurs: Longhai Zhu, Yafang Zhu, Qiuyue Pu, Jing Duan, Xianfeng Yu, Mingzhe Du, Yuting Jia, Penghao Wang, Rongyan Zhang, Mingzhi Zhang, Tingting Kang, Yongjun Cao, Hao Peng, Jijun Shi

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Bron: American journal of preventive cardiology, https://doi.org/10.1016/j.ajpc.2026.101785. Bijgewerkt 2026-10-06T00:59:44Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.