The inflammatory biomarker YKL-40 as a new prognostic marker for all-cause mortality in patients with heart failure.
BACKGROUND
Despite progress in management of patients with heart failure (HF) these patients still have a poor prognosis. We tested the hypothesis whether the inflammatory biomarker YKL-40 alone or in combination with high-sensitivity C-reactive protein (hs-CRP) and/or N-terminal-pro-B natriuretic peptide (NT-proBNP) could be a new prognostic biomarker for all-cause mortality in patients with HF.


RESULTS
A total of 717 of the 1000 patients with severe left ventricular systolic dysfunction included in the EchoCardiography and Heart Outcome Study were included in Denmark and had blood sample available for serum YKL-40 determination. Mean age of patients was 70 years, and 73% were male. During the 7 years follow-up period 458 patients died. Patients were categorised according to serum YKL-40 at entry into four quartiles: quartile I with median serum YKL-40=60 μg/L (5-95% Confidence interval (CI): 30-82), quartile II: YKL-40=107 μg/L (CI: 86-132), quartile III: YKL-40=169 μg/L (CI: 142-221), and quartile IV: YKL-40=286 μg/L (CI: 230-770). Hazard ratios for all-cause mortality were with quartile I as reference 1.33 (CI: 0.99-1.80), 1.35 (CI: 0.99-1.82), and 1.54 (CI: 1.14-2.08) for serum YKL-40 II to IV quartiles, respectively following multivariable adjustment for cardiovascular risk factors (age, left ventricular ejection fraction, gender, history of heart failure, ischemic heart disease, chronic pulmonary disease, diabetes mellitus, stroke, hypertension, NT-proBNP, hs-CRP, and renal function).


CONCLUSIONS
Serum YKL-40 is significantly associated with all-cause mortality in patients with HF and could potentially be a new prognostic biomarker in these patients.
Department of Medicine B, The Heart Centre, Rigshospitalet, Copenhagen University Hospital and Faculty of Health Sciences, Denmark.
Marina
M
Harutyunyan
Michael
M
Christiansen
Julia S
JS
Johansen
Lars
L
Køber
Christian
C
Torp-Petersen
Jens
J
Kastrup
D054392:Adipokines / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D000071451:Chitinase-3-Like Protein 1; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000401:mortality; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications / Q000401:mortality; D037102:Lectins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D012107:Research Design; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000150:complications / Q000401:mortality
D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D037102:Lectins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein