Serum YKL-40 predicts long-term mortality in patients with stable coronary disease: a prognostic study within the CLARICOR trial

TY - JOUR

T1 - Serum YKL-40 predicts long-term mortality in patients with stable coronary disease

T2 - a prognostic study within the CLARICOR trial

AU - Harutyunyan, Marina

AU - Gøtze, Jens P

AU - Winkel, Per

AU - Johansen, Julia S

AU - Hansen, Jørgen Fischer

AU - Jensen, Gorm Boje

AU - Hilden, Jørgen

AU - Kjøller, Erik

AU - Kolmos, Hans J

AU - Gluud, Christian

AU - Kastrup, Jens

N1 - Copyright © 2012 Elsevier GmbH. All rights reserved.

PY - 2013/7

Y1 - 2013/7

N2 - Objective: We investigated whether the inflammatory biomarker YKL-40 could improve the long-term prediction of death made by common risk factors plus high-sensitivity C-reactive protein (hs-CRP) and N-terminal-pro-B natriuretic peptide (NT-proBNP) in patients with stable coronary artery disease (CAD). Background: Non-hospitalized CAD patients are usually followed in general practice. There is a need for identify biomarkers which could help to foresee the prognoses of these patients. Elevated serum YKL-40 is a short-term predictor for myocardial infarction, cardiovascular mortality and all-cause mortality in patients with stable CAD. Methods: Serum YKL-40, hs-CRP, and NT-proBNP were measured in 4265 (97.6%) of the 4372 patients with stable CAD included in the CLARICOR trial, and death was registered in a 6-years follow-up period. Results: The median serum YKL-40 was 110. μg/L [IQR=93], hs-CRP 2.8. mg/L [IQR=4.74], and NT-proBNP 203. ng/L [IQR=407]. During 6 years follow-up period 923 (21.1%) patients died. After adjustment for type of intervention, risk factors (age, sex, hypertension, diabetes, smoking status, and previous myocardial infarction) and medical treatment (diuretics, digoxin, and statin) serum YKL-40 (transformed as ln(max(82, YKL-40/μg/L)) was significantly associated with all-cause mortality [hazard ratio (HR)=1.55, 95% CI=1.39-1.73, p<0.001]. After additional adjustment for ln(hs-CRP) and ln(NT-proBNP) this was still true [HR=1.38, 95% CI=1.21-1.53, p<0.001]. Conclusions: Serum YKL-40 is a predictor of long-term mortality in patients with stable CAD independent of common risk factors and ln(hs-CRP) and ln(NT-proBNP). Serum YKL-40 can be used for prognostication in these patients.

AB - Objective: We investigated whether the inflammatory biomarker YKL-40 could improve the long-term prediction of death made by common risk factors plus high-sensitivity C-reactive protein (hs-CRP) and N-terminal-pro-B natriuretic peptide (NT-proBNP) in patients with stable coronary artery disease (CAD). Background: Non-hospitalized CAD patients are usually followed in general practice. There is a need for identify biomarkers which could help to foresee the prognoses of these patients. Elevated serum YKL-40 is a short-term predictor for myocardial infarction, cardiovascular mortality and all-cause mortality in patients with stable CAD. Methods: Serum YKL-40, hs-CRP, and NT-proBNP were measured in 4265 (97.6%) of the 4372 patients with stable CAD included in the CLARICOR trial, and death was registered in a 6-years follow-up period. Results: The median serum YKL-40 was 110. μg/L [IQR=93], hs-CRP 2.8. mg/L [IQR=4.74], and NT-proBNP 203. ng/L [IQR=407]. During 6 years follow-up period 923 (21.1%) patients died. After adjustment for type of intervention, risk factors (age, sex, hypertension, diabetes, smoking status, and previous myocardial infarction) and medical treatment (diuretics, digoxin, and statin) serum YKL-40 (transformed as ln(max(82, YKL-40/μg/L)) was significantly associated with all-cause mortality [hazard ratio (HR)=1.55, 95% CI=1.39-1.73, p<0.001]. After additional adjustment for ln(hs-CRP) and ln(NT-proBNP) this was still true [HR=1.38, 95% CI=1.21-1.53, p<0.001]. Conclusions: Serum YKL-40 is a predictor of long-term mortality in patients with stable CAD independent of common risk factors and ln(hs-CRP) and ln(NT-proBNP). Serum YKL-40 can be used for prognostication in these patients.

KW - Adipokines

KW - Aged

KW - Biological Markers

KW - C-Reactive Protein

KW - Cardiotonic Agents

KW - Case-Control Studies

KW - Coronary Artery Disease

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Lectins

KW - Male

KW - Middle Aged

KW - Natriuretic Peptide, Brain

KW - Peptide Fragments

KW - Predictive Value of Tests

KW - Prognosis

KW - Risk Factors

KW - Survival Analysis

U2 - 10.1016/j.imbio.2012.10.015

DO - 10.1016/j.imbio.2012.10.015

M3 - Journal article

C2 - 23294528

SN - 0171-2985

VL - 218

SP - 945

EP - 951

JO - Immunobiology

JF - Immunobiology

IS - 7

ER -