title: Serum YKL-40, a prognostic marker in patients with large-artery atherosclerotic stroke.
abstract: OBJECTIVE
  Inflammation comprises important aspects of large-artery atherosclerosis (LAA) stroke pathophysiology. YKL-40 is a new and emerging biomarker that is associated with both acute and chronic inflammations. Elevated serum concentrations of YKL-40 have been reported in patients with atherosclerosis and other cardiovascular diseases. This study investigates whether serum YKL-40 concentrations on admission can predict 3-month clinical outcomes after LAA stroke.
  
  
  METHODS
  We recruited control patients (n=85) and those with LAA stroke (n=141) according to the TOAST classification system. The modified Rankin scale at 3 months after stroke was used to evaluate the prognosis. The prognostic accuracy was assessed by the receiver operating characteristic curve.
  
  
  RESULTS
  Serum YKL-40 level was significantly higher for LAA patients than for controls (P<.001). Patients with poor outcomes (n=36) had significantly increased serum YKL-40 concentrations on admission (P=.01). High YKL-40 levels predicted poor functional outcome (OR=6.47, P=.02). Moreover, the combination of YKL-40 level and the NIHSS score could improve the prognostic accuracy of the NIHSS in predicting functional outcome (combined areas under the curve, 0.87; 95% CI, 0.80-0.94; P<.001).
  
  
  CONCLUSIONS
  The level of serum YKL-40 is a significant and independent biomarker to predict the clinical outcome of LAA stroke.
authors.affiliation: Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.|Department of Rehabilitation, Wenzhou people's hospital, Wenzhou, China.
authors.forename: X-L
authors.initials: XL
authors.lastname: Chen
authors.affiliation: Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Li
authors.affiliation: Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: W-S
authors.initials: WS
authors.lastname: Huang
authors.affiliation: Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: Y-S
authors.initials: YS
authors.lastname: Lin
authors.affiliation: Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: J
authors.initials: J
authors.lastname: Xue
authors.affiliation: Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: B
authors.initials: B
authors.lastname: Wang
authors.affiliation: Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.|Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: K-L
authors.initials: KL
authors.lastname: Jin
authors.affiliation: Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: B
authors.initials: B
authors.lastname: Shao
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D002681:China / Q000453:epidemiology; D000071451:Chitinase-3-Like Protein 1 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020521:Stroke / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology
chemical_list: D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1
keywords: YKL-40; atherosclerosis; outcome; stroke