Effect of serum YKL-40 on coronary collateral development and SYNTAX score in stable coronary artery disease.
OBJECTIVE
Many studies have revealed a role of YKL-40 as a new inflammatory biomarker in angiogenesis, inflammation, atherosclerosis and cardiovascular events. Thus, the aim of this study was to investigate the association of serum YKL-40 level with coronary collateral development and SYNTAX score in patients with stable coronary artery disease.


METHODS
A total of 165 patients who had ≥90% stenosis in at least one major coronary artery were prospectively enrolled in the study. Collateral degree was graded according to Rentrop-Cohen classification. Patients with grade 2 or 3 collateral degree were included in good collateral group and patients with grade 0 or 1 collateral degree were included in poor collateral group. The patients were also classified according to SYNTAX criteria, those with low (≤22) and those with high (>22) SYNTAX score.


RESULTS
Serum YKL-40 and hs-CRP levels were significantly lower in good collateral group. Furthermore, YKL-40 level showed significant positive correlations with SYNTAX score (r=0.486, p<0.001) and hs-CRP level (r=0.340, p<0.001). In multivariate regression analysis, serum YKL-40 (odds ratio: 0.928; 95% confidence interval: 0.917-0.940; p<0.001), duration of ischemic symptom and total occlusion were independent predictors of good collateral development. In ROC curve analysis, a YKL-40 value cut-off point of ≥168.5 predicted the high SYNTAX score with a sensitivity of 81.0% and specificity of 72.4%.


CONCLUSIONS
Increased serum YKL-40 level was related with poor collateral development and high SYNTAX score. According to these findings YKL-40 can be used as a predictor of good collateral development and high SYNTAX score.
Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, Ankara, Turkey. Electronic address: mkakboga@yahoo.com.
Mehmet Kadri
MK
Akboga
Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey.
Ridvan
R
Yalcin
Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey.
Asife
A
Sahinarslan
Gazi University Medical Faculty, Department of Medical Biochemistry, Ankara, Turkey.
Canan
C
Yilmaz Demirtas
Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey.
Adnan
A
Abaci
D000368:Aged; D015415:Biomarkers / Q000097:blood; D000071451:Chitinase-3-Like Protein 1 / Q000097:blood*; D003097:Collateral Circulation / Q000502:physiology*; D017023:Coronary Angiography / Q000639:trends; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging*; D003326:Coronary Circulation / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index
D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1
Angiogenesis; Collateral development; Inflammation; SYNTAX score; YKL-40