P1750YKL-40 in patients with myocardial infarction is associated with survival rate

Abstract

Abstract Background YKL-40 is a protein released locally by inflammatory cells. Since inflammation has been implicated in the pathogenesis of atherosclerosis, YKL-40 is also considered as a potential biomarker and prognostic factor in cardiovascular diseases. Purpose The aim of the study was to analyze serum concentration of YKL-40 in patients with ischemic heart disease, and to verify if this parameter could be considered as a potential biomarker and prognostic factor in cardiovascular diseases. Methods The study included 158 participants, among them 52 patients with stable ischemic heart disease, 67 with acute coronary syndrome, and 39 controls without abnormalities in coronary vessels. Prior to the coronarography, a 5-ml sample of venous blood was collected from a peripheral vein of each patient. Serum concentration of YKL-40 was determined once, with an immunoenzymatic assay. For the next 4 years follow-up of patients was conducted, including hospitalizations and deaths. Results Patients with myocardial infarction presented with significantly higher serum concentrations of YKL-40 (ng/ml) than persons with stable ischemic disease (249.6±110.9 vs. 86.0±62.7; p<0.001) and the controls (249.6±110.9 vs. 60.2±20.1; p<0.001). No statistically significant differences were found in YKL-40 protein concentrations in patients with ST elevation (STEMI) and non-ST elevation myocardial infarction (NSTEMI) (255.1±110.3 vs. 236.6±113.9; p=NS). In the ROC analysis YKL-40 value above 360 ng/ml (AUC 0.93; 95% CI 0.86–0.98; p=0.00012) with 80% sensitivity and specificity predicted higher mortality up to 4 years after acute coronary syndrome (p=0.0014) (Figure 1). 4-year probability of survival Conclusion Higher serum concentration of YKL-40 at admission in patients with myocardial infarction is associated with higher mortality up to 4 years after acute coronary syndrome.