Increased YKL-40 levels in patients with isolated coronary artery ectasia: an observational study

Abstract

Objective: YKL-40, a new biomarker of localized inflammation, is secreted by macrophages within the atherosclerotic plaques. Coronary artery ectasia (CAE) is a clinical entity with unclear etiopathogenesis. Some studies have revealed that CAE may be a form of atherosclerosis that has more localized and intense inflammatory properties than atherosclerosis. The goal of this study was to investigate YKL-40 and C-reactive protein (CRP) levels in patients with isolated CAE compared to patients with normal coronary arteries (NCA) and coronary artery disease (CAD). Methods: Our study has an observational and cross-sectional design. Forty-nine patients with isolated CAE (mean age: 60±10 years), 30 age-and gender-matched control participants with NCA (30 patients, mean age: 58±12 years) and 30 patients with CAD (mean age: 61±10 years), were included in the study. The relationship between YKL-40, CRP levels and the presence of CAE was investigated. Univariate and multiple logistic regression analysis were used for analysis of independent variables to predict CAE. Results: Serum YKL-40 levels were significantly different among study groups (NCA: 110±53 μg/L, CAE: 144±68 and CAD: 180±117, p=0.005). CAD group and CAE group had significantly higher YKL-40 levels than NCA group (p=0.004 and p=0.015, respectively). CRP was not significantly different between three groups. In addition, there were no any statistically significant differences, with respect to age, gender, the presence of hypertension or diabetes mellitus, and the smoking status (p>0.05). Logistic regression analysis revealed only YKL-40 level as the determinant of CAE (OR: 1.010, 95% CI: 1.001-1.019, p=0.027). Conclusion: YKL-40 levels in patients with isolated CAE compared to patients with NCA were found significantly high and only YKL-40 level was established as the determinant of CAE. We believe that further studies are needed to clarify the possible causative roles of YKL-40 in patients with isolated CAE. (

Giant left atrial myxoma with left and right coronary system blood supply accompanying mitral stenosis; real-time three- dimensional echocardiography imaging

“…Erdogan et al (8) report in the Anatolian Journal of Cardiology that serum YKL-40 levels in patients with isolated CAE and coronary artery disease are significantly higher than that in patients with normal coronary artery (NCA) and this result in those with isolated CAE remains significant even after adjusting for multiple variables. Furthermore, the present study demonstrates, that C-reactive protein (CRR) level in between those with isolated CAE and NCA does not have a significant difference, which is different from the previous study (4).…”

“…Rrevious studies have reported that circulating YKL-40 level is elevated in patients with diabetes and obesity (7)(8)(9)(10). The entire population in the present study has high body mass index, and the prevalence of diabetes in patients with CAE and CAD tends to be higher than in those with NCA, although there is no significant difference between the groups.…”

Could YKL-40 be used as a new marker for coronary artery ectasia?

“…Previous studies have reported that circulating YKL-40 level is elevated in patients with diabetes and obesity (7)(8)(9)(10). The entire population in the present study has high body mass index, and the prevalence of diabetes in patients with CAE and CAD tends to be higher than in those with NCA, although there is no significant difference between the groups.…”

“…Erdoğan et al (8) report in the Anatolian Journal of Cardiology that serum YKL-40 levels in patients with isolated CAE and coronary artery disease are significantly higher than that in patients with normal coronary artery (NCA) and this result in those with isolated CAE remains significant even after adjusting for multiple variables. Furthermore, the present study demonstrates that C-reactive protein (CRP) level in between those with isolated CAE and NCA does not have a significant difference, which is different from the previous study (4).…”

Diagnostic Value of Serum YKL‐40 Level for Coronary Artery Disease: A Meta‐Analysis

“…1). Eventually, 11 clinical case-control studies with a total of 1,175 CAD patients and 1,261 healthy subjects met our inclusion criteria for quantitative data analysis (19)(20)(21)(22), (26)(27)(28)(29)(30)(31)(32). The range of publication years of the eligible studies ranged from 2007 to 2013.…”