title: High serum YKL-40 concentration is associated with cardiovascular and all-cause mortality in patients with stable coronary artery disease.
abstract: OBJECTIVE
  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).
  
  
  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/microg/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).
  
  
  CONCLUSIONS
  High serum YKL-40 is associated with MI, cardiovascular and all-cause mortality in patients with stable CAD.
authors.affiliation: Department of Medicine B, Cardiac Catheterization Laboratory 2014, The Heart Centre, Rigshospitalet, Copenhagen University Hospital and Faculty of Health Sciences, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. jens.kastrup@rh.regionh.dk
authors.forename: Jens
authors.initials: J
authors.lastname: Kastrup
authors.forename: Julia S
authors.initials: JS
authors.lastname: Johansen
authors.forename: Per
authors.initials: P
authors.lastname: Winkel
authors.forename: Jørgen Fischer
authors.initials: JF
authors.lastname: Hansen
authors.forename: Per
authors.initials: P
authors.lastname: Hildebrandt
authors.forename: Gorm Boje
authors.initials: GB
authors.lastname: Jensen
authors.forename: Christian M
authors.initials: CM
authors.lastname: Jespersen
authors.forename: Erik
authors.initials: E
authors.lastname: Kjøller
authors.forename: Hans Jørn
authors.initials: HJ
authors.lastname: Kolmos
authors.forename: Inga
authors.initials: I
authors.lastname: Lind
authors.forename: Henrik
authors.initials: H
authors.lastname: Nielsen
authors.forename: Christian
authors.initials: C
authors.lastname: Gluud
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000401:mortality; D054392:Adipokines; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D000071451:Chitinase-3-Like Protein 1; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D037102:Lectins; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins