Abstract

Atherosclerotic coronary artery disease is considered to be the most common cause of myocardial ischemia. YKL-40, a chitin-binding acute phase glycoprotein, has been found to be expressed by macrophages in atherosclerotic plaques. The YKL-40 could potentially be a new useful biomarker to monitor severity and predict early diagnosis of acute coronary syndrome (ACS) in ischemic heart disease (IHD) patients. The aim of this study was to measure the level of serum YKL-40 in IHD patients and to clarify its role as a potentially beneficial diagnostic marker in those patients. Serum YKL-40 was measured in 60 IHD patients and 30 healthy controls. According to chest pain analysis, ECG changes, and cardiac enzymes, the IHD patients were categorized into patients with stable angina and patients with ACS. The median level of YKL-40 (pg/ml) was significantly elevated in patients with IHD compared with the control group (2080 (575.5–5974.6) vs 522.6 (133.2–769.5), respectively; P<0.001). The median level of YKL-40 was also significantly higher in patients with ACS compared with patients with stable angina (2436 (576–5975) vs 1015 (675–1822), respectively; P<0.001). There was a positive correlation between YKL-40 levels and high-sensitivity C-reactive protein (mg/dl) in all studied groups of IHD patients. However, no significant correlation was detected between YKL-40 and age, systolic or diastolic blood pressure, and lipid profile in patients with IHD. YKL-40 might play an important role as a diagnostic and prognostic marker in patients with IHD and in patients with ACS.

Highlights

  • Atherosclerotic coronary artery disease is considered to be the most common cause of myocardial ischemia

  • YKL-40 level was significantly higher in ischemic heart disease (IHD) patients in comparison with age and sex matched controls

  • YKL-40 was increased in stepwise manner in acute coronary syndrome (ACS) patients in comparison with SA patients and in AMI patients (STEMI and non-ST-segment elevation myocardial infarction (NSTEMI)) in comparison with unstable angina (UA) patients

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Summary

Introduction

Atherosclerotic coronary artery disease is considered to be the most common cause of myocardial ischemia. YKL-40, a chitin-binding acute phase glycoprotein, has been found to be expressed by macrophages in atherosclerotic plaques. The YKL-40 could potentially be a new useful biomarker to monitor severity and predict early diagnosis of acute coronary syndrome (ACS) in ischemic heart disease (IHD) patients. YKL-40 is a chitin-binding acute phase glycoprotein [6] that is expressed in association with inflammatory process, extracellular matrix degradation, and angiogenesis [7]. It was identified in 1989 to be secreted by the human osteosarcoma cell line [8]. YKL-40 could potentially be a new useful biomarker to monitor disease severity and predict prognosis and survival in patients with IHD [15]

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