High serum YKL-40 concentration is associated with cardiovascular and all-cause mortality in patients with stable coronary artery disease

J Kastrup, JS Johansen, P Winkel… - European heart …, 2009 - academic.oup.com
J Kastrup, JS Johansen, P Winkel, JF Hansen, P Hildebrandt, GB Jensen, CM Jespersen…
European heart journal, 2009academic.oup.com
Aims Macrophages in atherosclerotic plaques secrete YKL-40. We tested the hypothesis if
high serum YKL-40 concentration predicts coronary events and death of patients with stable
coronary artery disease (CAD). Methods and results During the 2.6 years follow-up period
(median 2.77 year, interquartile range 0.23 year), 270 patients among the 4298 patients with
stable CAD in the CLARICOR trial suffered myocardial infarction (MI) and 377 died (187
classified as cardiovascular death). Serum YKL-40 transformed as Y= log [max (82, serum …
Aims
Macrophages in atherosclerotic plaques secrete YKL-40. We tested the hypothesis if high serum YKL-40 concentration predicts coronary events and death of patients with stable coronary artery disease (CAD).
Methods and results
During the 2.6 years follow-up period (median 2.77 year, interquartile range 0.23 year), 270 patients among the 4298 patients with stable CAD in the CLARICOR trial suffered myocardial infarction (MI) and 377 died (187 classified as cardiovascular death). Serum YKL-40 transformed as Y=log[max(82, serum YKL-40/µg/L)] was significantly associated with cardiovascular death [hazard ratio (HR) = 1.88, 95% confidence interval (CI) = 1.54–2.31, P < 0.001], all-cause mortality (HR = 2.01, 95% CI = 1.75–2.31, P < 0.001), and MI (HR = 1.38, 95% CI = 1.13–1.68, P = 0.002). Following multivariable adjustment for cardiovascular risk factors (age, sex, previous MI, smoking status, hypertension, diabetes mellitus) and selected medical treatments Y contributed significantly to prediction of all-cause mortality (P < 0.001) and cardiovascular mortality (P = 0.001), but not MI (P = 0.25).
Conclusion
High serum YKL-40 is associated with MI, cardiovascular and all-cause mortality in patients with stable CAD.
Oxford University Press