Plasma YKL-40 levels correlate with the severity of coronary atherosclerosis assessed with the SYNTAX score

Abstract

INTRODUCTION YKL-40 is a protein released locally by inflammatory cells. Thus, it may constitute a biomarker of inflammatory conditions, such as atherosclerosis. OBJECTIVES The aim of the study was to determine YKL-40 levels in patients with ischemic heart disease and to analyze the correlation of this biomarker with the severity of coronary atherosclerosis. PATIENTS AND METHODS The study included 158 patients: 52 with stable ischemic heart disease and 67 with acute coronary syndrome: ST-segment elevation myocardial infarction (STEMI; n = 47) or non- ST-segment elevation myocardial infarction (NSTEMI; n = 20). The control group included 39 individuals without abnormalities in coronary vessels. We evaluated plasma YKL-40 levels and their correlation with the severity of coronary atherosclerosis assessed with the SYNTAX score. RESULTS Patients with myocardial infarction had higher plasma YKL-40 levels than those with stable ischemic disease (median [range], 235.3 [161.6-366.1] ng/ml vs 61.2 [53.1-83.1] ng/ml; P <0.001) or controls (median [range], 235.3 [161.6-366.1] ng/ml vs 55.7 [51.2-75.2] ng/ml; P <0.001). No differences were found in YKL-40 concentrations between STEMI and NSTEMI patients (median [range], 263 [150.3-363.7] ng/ml and 214.9 [163.4-367.6] ng/ml, respectively; P = 0.7). The SYNTAX score in patients with ischemic heart disease correlated positively with YKL-40 concentrations (R = 0.34; P <0.001). CONCLUSIONS YKL-40 can be considered a potential biomarker of coronary atherosclerosis severity.