High serum YKL-40 concentration is associated with cardiovascular and all-cause mortality in patients with stable coronary artery disease
High serum YKL-40 concentration is associated with cardiovascular and all-cause mortality in patients with stable coronary artery disease
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DOI：
10.1093/eurheartj/ehp049
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发表时间：
2009-05-01
影响因子：
39.3
通讯作者：
Gluud, Christian
中科院分区：
文献类型：
--
作者：
Kastrup, Jens;Johansen, Julia S.;Gluud, Christian
动脉粥样硬化斑块中的巨噬细胞分泌YKL-40。我们检验了高血清YKL-40浓度是否预测稳定型冠状动脉疾病（CAD）患者的冠状动脉事件和死亡的假设。（中位数2.77年，四分位距0.23年），在CANICOR试验中，4298例稳定型CAD患者中有270例发生心肌梗死（MI），377例死亡（187例归类为心血管死亡）。血清YKL-40转换为Y=log[max（82，血清YKL-40/μ g/L）]与心血管死亡显著相关[风险比（HR）= 1.88，95%可信区间（CI）= 1.54-2.31，P < 0.001]，全因死亡（HR = 2.01，95%CI = 1.75-2.31，P < 0.001）和MI（HR = 1.38，95%CI = 1.13-1.68，P = 0.002）。在对心血管危险因素进行多变量校正后（年龄、性别、既往MI、吸烟状况、高血压、糖尿病）和选定的药物治疗Y对全因死亡率的预测有显著贡献。（P < 0.001）和心血管死亡率高血清YKL-40与稳定型CAD患者的MI、心血管和全因死亡率相关。
Macrophages in atherosclerotic plaques secrete YKL-40. We tested the hypothesis if high serum YKL-40 concentration predicts coronary events and death of patients with stable coronary artery disease (CAD).During the 2.6 years follow-up period (median 2.77 year, interquartile range 0.23 year), 270 patients among the 4298 patients with stable CAD in the CLARICOR trial suffered myocardial infarction (MI) and 377 died (187 classified as cardiovascular death). Serum YKL-40 transformed as Y=log[max(82, serum YKL-40/mu g/L)] was significantly associated with cardiovascular death [hazard ratio (HR) = 1.88, 95% confidence interval (CI) = 1.54-2.31, P < 0.001], all-cause mortality (HR = 2.01, 95% CI = 1.75-2.31, P < 0.001), and MI (HR = 1.38, 95% CI = 1.13-1.68, P = 0.002). Following multivariable adjustment for cardiovascular risk factors (age, sex, previous MI, smoking status, hypertension, diabetes mellitus) and selected medical treatments Y contributed significantly to prediction of all-cause mortality (P < 0.001) and cardiovascular mortality (P = 0.001), but not MI (P = 0.25).High serum YKL-40 is associated with MI, cardiovascular and all-cause mortality in patients with stable CAD.