Why the study?
The role of YKL-40 in ST segment elevation myocardial infarction and its relationship to CRP and MMP-9 remained to be investigated.
Do elevated serum YKL-40 levels predict worse clinical outcomes and correlate with inflammatory markers in patients with STEMI?
Cohort (n=358)
No
Do elevated serum YKL-40 levels predict worse clinical outcomes and correlate with inflammatory markers in patients with STEMI?
Effect estimate: 3.9 (95% CI 1.9-8.2)
p-value: p=< .001
Elevated serum YKL-40 levels in STEMI patients correlate with higher inflammatory markers (CRP, MMP-9) and predict worse clinical outcomes including MACE and mortality at 6 months.
May support YKL-40 as prognostic biomarker in STEMI; hypothesis-generating and should not change practice without validation.
OBJECTIVE: To investigate the role of YKL-40 in ST segment elevation myocardial infarction (STEMI) and its relationship to C-reactive protein (CRP) and matrix metalloproteinase-9 (MMP-9). METHODS: This prospective study included 358 STEMI patients who were sent to the Emergency Department of our hospital from April 2014 to December 2017. Serum levels of YKL-40, CRP and MMP-9 were determined using commercially available Enzyme linked immunosorbent assay (ELISA) kits. Major adverse cardiovascular events (MACE) and overall survival time were analyzed. RESULTS: GRACE scores (P < .001) and the levels of YKL-40 (P < .001), MMP-9 (P < .001), and CRP (P < .001) were significantly higher in deceased patients compared to those that survived. The levels of CRP (P = .007) and MMP-9 (P = .022) were significantly higher in the high YKL-40 group. The GRACE scores were also significantly elevated (P = .011, 95% CI 2.1 (-9.7 to -1.3)). Cumulative MACE rates and cardiac death rates were significantly higher in the high YKL-40 group (P < .001, 95% CI 3.9 (1.9-8.2)). Overall survival times were significantly longer in patients with lower YKL-40 levels (P < .0001). CONCLUSION: Elevated YKL-40 levels positively correlate with CRP and MMP-9 levels and are associated with clinical outcomes including MACE and 6-month survival in STEMI patients.
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Tan et al. (2019) conducted a cohort in ST segment elevation myocardial infarction (STEMI) (n=358). High serum YKL-40 levels vs. Lower serum YKL-40 levels was evaluated on Cumulative MACE and cardiac death rates (3.9, 95% CI 1.9-8.2, p=< .001).
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