High serum YKL-40 concentration is associated with cardiovascular and all-cause mortality in patients with stable coronary artery disease

• Published in: European heart journal 2009-05, Vol.30 (9), p.1066-1072
• Main Authors: Kastrup, Jens, Johansen, Julia S., Winkel, Per, Hansen, Jørgen Fischer, Hildebrandt, Per, Jensen, Gorm Boje, Jespersen, Christian M., Kjøller, Erik, Kolmos, Hans Jørn, Lind, Inga, Nielsen, Henrik, Gluud, Christian
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - blood; Acute Coronary Syndrome - mortality; Adipokines; Aged; Biological and medical sciences; Biomarker; Biomarkers - blood; Cardiology. Vascular system; Cause of Death; Chitinase-3-Like Protein 1; Coronary Angiography; Coronary artery disease; Coronary Artery Disease - blood; Coronary Artery Disease - mortality; Coronary heart disease; Enzyme-Linked Immunosorbent Assay; Female; Glycoproteins - blood; Heart; Heart disease; Humans; Lectins; Male; Medical sciences; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - mortality; Predictive Value of Tests; Prognosis; Prognostic factors; Survival Analysis; YKL-40
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehp049

Aims Macrophages in atherosclerotic plaques secrete YKL-40. We tested the hypothesis if high serum YKL-40 concentration predicts coronary events and death of patients with stable coronary artery disease (CAD). Methods and results During the 2.6 years follow-up period (median 2.77 year, interquartile range 0.23 year), 270 patients among the 4298 patients with stable CAD in the CLARICOR trial suffered myocardial infarction (MI) and 377 died (187 classified as cardiovascular death). Serum YKL-40 transformed as Y=log[max(82, serum YKL-40/µg/L)] was significantly associated with cardiovascular death [hazard ratio (HR) = 1.88, 95% confidence interval (CI) = 1.54–2.31, P < 0.001], all-cause mortality (HR = 2.01, 95% CI = 1.75–2.31, P < 0.001), and MI (HR = 1.38, 95% CI = 1.13–1.68, P = 0.002). Following multivariable adjustment for cardiovascular risk factors (age, sex, previous MI, smoking status, hypertension, diabetes mellitus) and selected medical treatments Y contributed significantly to prediction of all-cause mortality (P < 0.001) and cardiovascular mortality (P = 0.001), but not MI (P = 0.25). Conclusion High serum YKL-40 is associated with MI, cardiovascular and all-cause mortality in patients with stable CAD.