Plasma YKL-40 and recovery of left ventricular function after acute myocardial infarction.
BACKGROUND
Plasma YKL-40 is increased early in patients with ST-elevation myocardial infarction (STEMI). It is not known whether plasma YKL-40 is related to infarct size and recovery of ventricular function after primary percutaneous coronary intervention (PCI) of STEMI and whether granulocyte colony-stimulating factor (G-CSF) therapy influence plasma YKL-40 concentration.


METHODS
A total of 72 patients (age: 56 +/- 9 years (mean +/- SD), 56 men and 16 women) with STEMI treated with PCI were included in a double-blind, randomized, placebo-controlled trial with subcutaneous G-CSF or placebo injections from day 1 to 7 after the STEMI. Plasma YKL-40, high-sensitivity C-reactive protein (hs-CRP) and CK-MB concentrations were measured at baseline and during the first month. Infarct size and left ventricular ejection fraction (LVEF) were measured by magnetic resonance imaging at baseline and after 6 months.


RESULTS
Baseline plasma YKL-40 was increased (median 92 microg/L) compared to healthy subjects (median 34 microg/L, p <0.001). In the placebo group hs-CRP and YKL-40 correlated at baseline (p = 0.04) and day 3 (p = 0.01), but not at day 7 and 30. Moreover, YKL-40 correlated negatively to LVEF recovery (p = 0.04) but not infarct size. G-CSF injections increased YKL-40 compared to placebo (p <0.001), but were not associated with infarct size or LVEF recovery.


CONCLUSIONS
Plasma YKL-40 was significantly increased in STEMI patients at admission and G-CSF treatment caused a further increase in YKL-40. Plasma YKL-40 may be an indirect marker of LVEF recovery, independent of hs-CRP, and higher plasma YKL-40 indicates a lower recovery.
Hedegaard
Anne
A
Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital and University of Copenhagen, Faculty of Health Sciences, Copenhagen, Denmark.
Ripa
Rasmus Sejersten
RS
Johansen
Julia S
JS
Jørgensen
Erik
E
Kastrup
Jens
J
D054392:Adipokines; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001769:Blood / Q000187:drug effects; D002097:C-Reactive Protein / Q000378:metabolism; D000071451:Chitinase-3-Like Protein 1; D052279:Creatine Kinase, MB Form / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation / Q000097:blood; D037102:Lectins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000503:physiopathology
D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins; D016179:Granulocyte Colony-Stimulating Factor; D002097:C-Reactive Protein; D052279:Creatine Kinase, MB Form