YKL-40 as biomarker: Focus on cardiovascular disease

Abstract

Coronary artery disease is the most common cause of death in Western countries today, and the number of patients is still increasing. Medical therapies and revascularization by percutaneous coronary intervention or coronary bypass surgery have reduced the mortality significantly and improved quality of life for patients with coronary artery disease. However, the available treatment is not always sufficient and many patients are still plagued by a high frequency of angina pectoris or heart failure symptoms, hospital admissions, and an overall poor prognosis in spite of an intense treatment strategy. There is no simple clinical parameter available to monitor whether a given treatment is sufficient with regard to preventing major cardiovascular events such as myocardial infarction, heart failure, stroke, or death. New biomarkers are needed, which alone or in combination with other risk markers could be useful in monitoring treatment and as prognostic markers for future cardiovascular events in patients with ischemic heart disease. Epidemiological and clinical studies have shown a strong and consistent relationship between biomarkers of inflammation and the risk of cardiovascular events. YKL-40 is a new potential biomarker of inflammation and YKL-40 has been found elevated in patients with both acute and stable chronic cardiovascular disease. Therefore, YKL-40 could potentially be a new useful biomarker to monitor disease severity and predict prognosis and survival in patients with ischemic heart disease. This chapter will review present knowledge about YKL-40 in cardiac patients and discuss whether YKL-40 could be used to monitor therapies and for prognostic evaluation in patients with cardiovascular disease.