Key result
Baseline serum YKL-40 was elevated in atrial fibrillation and independently predicted AFib recurrence at 6 months (adjusted OR 1.02; 95% CI 1.00-1.04; P=0.016).
Why the study?
Is serum YKL-40 elevated in supraventricular arrhythmias and does it predict recurrence after therapy?
Observational (n=90)
Is serum YKL-40 elevated in supraventricular arrhythmias and does it predict recurrence after therapy?
Odds Ratio: 1.02 (95% CI 1–1.04)
p-value: p=0.016
Serum YKL-40 is elevated specifically in atrial fibrillation compared to other supraventricular arrhythmias, responds to therapy, and predicts long-term recurrence.
YKL-40 may aid AF recurrence risk stratification; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND: The inflammatory glycoprotein chitinase-3-like protein 1 or YKL-40 has emerged as a potential biomarker of cardiovascular diseases, including atrial fibrillation (AFib). We sought to assess YKL-40 in a wide spectrum of supraventricular arrhythmias besides AFib in comparison with other inflammatory markers. METHODS: We determined serum levels of YKL-40, C-reactive protein (CRP) and IL-6 in 70 patients with AFib, atrial flutter, atrioventricular node reentry tachycardia or other supraventricular tachycardias before, immediately after therapy and 1 week after therapy; 20 healthy patients served as controls. Patients were subsequently followed for 6 months for arrhythmia recurrence. RESULTS: Baseline YKL-40 was significantly elevated in AFib patients [99.5 (65.5,194) ng/ml versus 47.2 (38.9,51.6) ng/ml in controls, P < 0.001], but not in patients with other arrhythmias. YKL-40 levels correlated positively with left atrial volume index (Spearman's rho = 0.853, P < 0.001). Its levels dropped significantly 1 week posttreatment only in AFib (P = 0.009 versus baseline); CRP and IL-6 remained practically stable throughout the study. Arrhythmia recurrence at 6 months occurred in 13 patients (19%), including 11 with AFib and 2 with atrial flutter. Baseline YKL-40 was independently associated with AFib recurrence (adjusted odds ratio = 1.02, 95% confidence interval = 1.00-1.04, P = 0.016). Neither CRP nor IL-6 was associated with AFib recurrence. CONCLUSION: Serum YKL-40 was elevated only in AFib and not in other supraventricular arrhythmias. In AFib, YKL-40 levels were responsive to therapy and predicted long-term recurrence.
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Michelakakis et al. (2017) conducted an observational in Supraventricular arrhythmias (n=90). Baseline YKL-40 levels vs. Healthy controls was evaluated on Atrial fibrillation recurrence at 6 months (OR 1.02, 95% CI 1.00-1.04, p=0.016). Baseline serum YKL-40 was elevated in atrial fibrillation and independently predicted AFib recurrence at 6 months (adjusted OR 1.02; 95% CI 1.00-1.04; P=0.016).
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