High serum YKL-40 concentration is associated with cardiovascular and all-cause mortality in patients with stable coronary artery disease.
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.
Kastrup
Jens
J
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
Johansen
Julia S
JS
Winkel
Per
P
Hansen
Jørgen Fischer
JF
Hildebrandt
Per
P
Jensen
Gorm Boje
GB
Jespersen
Christian M
CM
Kjøller
Erik
E
Kolmos
Hans Jørn
HJ
Lind
Inga
I
Nielsen
Henrik
H
Gluud
Christian
C
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
D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins