The Correlation between Serum Levels of sST2 and PCSK9 and Cardiovascular Function and Prognosis in Patients with H-type Hypertension

ZHOU Tingting; BAI Yejun; LIU Min; LI Zhigang; LIU Lingling

doi:10.12102/j.issn.1672-1349.2025.07.018

Abstract：Objective: To analyze the relationship between serum soluble tumor necrosis factor-α-induced protein 2 (sST2), proprotein convertase subtilisin/kexin type 9 (PCSK9) levels and cardiac function and prognosis in patients with H-type hypertension. Methods: A total of 124 patients with H-type hypertension treated at Xuzhou Central Hospital from January 2021 to March 2022 were selected as the H-type hypertension group, 87 patients with non-H-type hypertension as the non-H-type hypertension group, and 100 healthy individuals as the control group. According to whether cardiovascular events occurred, patients with H-type hypertension were divided into the good prognosis group and poor prognosis group. The levels of serum sST2 and PCSK9 were measured by enzyme-linked immunosorbent assay (ELISA). The correlation between serum sST2, PCSK9 levels and cardiac function indicators was analyzed; the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum sST2 and PCSK9 levels for prognosis in patients with H-type hypertension; logistic regression analysis was performed to identify factors affecting poor prognosis in H-type hypertension. Results: The serum levels of sST2 and PCSK9 in the H-type hypertension group were higher than those in the non-H-type hypertension group and the control group (P < 0.05), and the non-H-type hypertension group had higher serum sST2 and PCSK9 levels than the control group (P < 0.05). The serum levels of sST2 and PCSK9 were significantly lower in the good prognosis group compared to the poor prognosis group (P < 0.05). Patients with H-type hypertension had significantly higher levels of homocysteine, low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and left ventricular mass index compared to the non-H-type hypertension group (P < 0.05), while high-density lipoprotein cholesterol (HDL-C), left ventricular ejection fraction, and cardiac index were significantly lower (P < 0.05). In patients with H-type hypertension, serum sST2 and PCSK9 levels were positively correlated (r = 0.337, P < 0.05), and both were negatively correlated with left ventricular ejection fraction and cardiac index (P < 0.05), but positively correlated with LVEDD, LVESD, left ventricular mass index, homocysteine, LDL-C, and CRP (P < 0.05). The area under the ROC curve (AUC) for combined detection of sST2 and PCSK9 in predicting poor prognosis in patients with H-type hypertension was higher than that of individual detection (ZsST2-joint = 3.074, P = 0.002; ZPCSK9-joint = 2.176, P = 0.030). sST2, PCSK9, homocysteine, LDL-C, and CRP were identified as factors influencing poor prognosis in patients with H-type hypertension (P < 0.05). Conclusion: The serum levels of sST2 and PCSK9 in patients with H-type hypertension are closely related to cardiac function and prognosis.