Increased serum YKL-40 and C-reactive protein levels are associated with angiographic lesion progression in patients with coronary artery disease

Objective: YKL-40 is a pro-inflammatory protein highly expressed in atherosclerotic plaques, and is related to prognosis of patients with coronary artery disease (CAD). This study aimed to assess the possible association between YKL-40 and coronary lesion progression in CAD patients. Methods: A total of 313 patients with CAD, who underwent percutaneous coronary intervention (PCI) and follow-up angiography (mean 13.2 +/- 3.2 months) were recruited. Serum YKL-40 and high-sensitivity C-reactive protein (hsCRP) levels were measured using ELISA kits. Results: Baseline serum YKL-40 and hsCRP levels were higher in those with lesion progression (all p < 0.001 vs. patients without lesion progression), and correlated significantly with change of lumen diameter stenosis and cumulative coronary obstruction score (all p < 0.01). Multivariable logistic regression analysis revealed that after adjusting for conventional risk factors, number of total coronary artery lesions, YKL-40 and hsCRP levels were independent determinants of lesion progression. An area under the curve of YKL-40 and hsCRP was 0.744 (CI 95% 0.685-0.804, p < 0.001) and 0.716 (CI 95% 0.657-0.776, p < 0.001), respectively. The optimal values of cut-off point were 74.98 ng/ml (sensitivity 70%, specificity 71%) for YKL-40 and 3.21 mg/l (sensitivity 66%, specificity 68%) for hsCRP to predict lesion progression. Conclusion: Increased serum YKL-40 and hsCRP levels are independently associated with lesion progression in patients with CAD. (C) 2010 Elsevier Ireland Ltd. All rights reserved.