Serum YKL-40 predicts adverse clinical outcomes in patients with chronic heart failure.
BACKGROUND
Human cartilage glycoprotein-39 (YKL-40), a novel inflammatory marker, is secreted into circulation by macrophages, neutrophils, chondrocytes, vascular smooth muscle cells and cancer cells. Circulating levels of YKL-40 are related to the degree of inflammation, tissue remodeling, fibrosis, and cancer progression.


RESULTS
We examined serum YKL-40 levels in 121 patients with chronic heart failure (CHF) and 39 control subjects. The patients were followed up to register cardiac events for a mean of 720 days. Serum YKL-40 levels were measured by sandwich enzyme-linked immunoassay. Serum YKL-40 was significantly higher in New York Heart Association (NYHA) Class III/IV patients than control subjects and NYHA Class I/II patients (P < .0001). Serum YKL-40 was also higher in patients with cardiac events than in event-free patients (P = .0023). Cutoff value of YKL-40 was determined by receiver operating characteristic curve analysis. Kaplan-Meier analysis demonstrated that high level of YKL-40 was associated with higher rates of cardiac events than low levels of YKL-40 (P = .003). The multivariate Cox hazard analysis demonstrated that serum YKL-40 level was an independent prognostic factor of cardiac events (hazard ratio 2.085, 95% confidence interval 1.233-3.499, P < .0048).


CONCLUSIONS
Serum YKL-40, a new marker of inflammation, was increased in CHF, and YKL-40 detected high risk patients for adverse outcomes in CHF.
First Department of Internal Medicine, Yamagata University School of Medicine, Yamagata, Japan.
Olga
O
Bilim
Yasuchika
Y
Takeishi
Tatsuro
T
Kitahara
Mitsunori
M
Ishino
Toshiki
T
Sasaki
Satoshi
S
Suzuki
Tetsuro
T
Shishido
Isao
I
Kubota
D054392:Adipokines; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D000071451:Chitinase-3-Like Protein 1; D003404:Creatinine / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005919:Glomerular Filtration Rate; D006023:Glycoproteins / Q000097:blood*; D006325:Heart Atria / Q000473:pathology; D006333:Heart Failure / Q000097:blood* / Q000145:classification / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000097:blood; D007249:Inflammation / Q000097:blood; D037102:Lectins / Q000097:blood*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood; D014527:Uric Acid / Q000097:blood
D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins; D020097:Natriuretic Peptide, Brain; D014527:Uric Acid; D012964:Sodium; D003404:Creatinine