Akboga Mehmet Kadri, Yalcin Ridvan, Sahinarslan Asife, Yilmaz Demirtas Canan, Abaci Adnan
Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, Ankara, Turkey.
Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey.
Int J Cardiol. 2016 Dec 1;224:323-327. doi: 10.1016/j.ijcard.2016.09.042. Epub 2016 Sep 17.
Many studies have revealed a role of YKL-40 as a new inflammatory biomarker in angiogenesis, inflammation, atherosclerosis and cardiovascular events. Thus, the aim of this study was to investigate the association of serum YKL-40 level with coronary collateral development and SYNTAX score in patients with stable coronary artery disease.
A total of 165 patients who had ≥90% stenosis in at least one major coronary artery were prospectively enrolled in the study. Collateral degree was graded according to Rentrop-Cohen classification. Patients with grade 2 or 3 collateral degree were included in good collateral group and patients with grade 0 or 1 collateral degree were included in poor collateral group. The patients were also classified according to SYNTAX criteria, those with low (≤22) and those with high (>22) SYNTAX score.
Serum YKL-40 and hs-CRP levels were significantly lower in good collateral group. Furthermore, YKL-40 level showed significant positive correlations with SYNTAX score (r=0.486, p<0.001) and hs-CRP level (r=0.340, p<0.001). In multivariate regression analysis, serum YKL-40 (odds ratio: 0.928; 95% confidence interval: 0.917-0.940; p<0.001), duration of ischemic symptom and total occlusion were independent predictors of good collateral development. In ROC curve analysis, a YKL-40 value cut-off point of ≥168.5 predicted the high SYNTAX score with a sensitivity of 81.0% and specificity of 72.4%.
Increased serum YKL-40 level was related with poor collateral development and high SYNTAX score. According to these findings YKL-40 can be used as a predictor of good collateral development and high SYNTAX score.
许多研究揭示了YKL - 40作为血管生成、炎症、动脉粥样硬化和心血管事件中一种新的炎症生物标志物的作用。因此，本研究的目的是探讨稳定型冠心病患者血清YKL - 40水平与冠状动脉侧支循环发育及SYNTAX评分的相关性。
共有165例至少一支主要冠状动脉狭窄≥90%的患者前瞻性纳入本研究。根据Rentrop - Cohen分类法对侧支循环程度进行分级。侧支循环程度为2级或3级的患者纳入良好侧支循环组，侧支循环程度为0级或1级的患者纳入不良侧支循环组。患者还根据SYNTAX标准进行分类，即SYNTAX评分低（≤22）和高（>22）的患者。
良好侧支循环组血清YKL - 40和hs - CRP水平显著降低。此外，YKL - 40水平与SYNTAX评分（r = 0.486，p < 0.001）和hs - CRP水平（r = 0.340，p < 0.001）呈显著正相关。在多因素回归分析中，血清YKL - 40（比值比：0.928；95%置信区间：0.917 - 0.940；p < 0.001）、缺血症状持续时间和完全闭塞是良好侧支循环发育的独立预测因素。在ROC曲线分析中，YKL - 40值截断点≥168.5预测高SYNTAX评分的敏感性为81.0%，特异性为72.4%。
血清YKL - 40水平升高与侧支循环发育不良和高SYNTAX评分相关。根据这些发现，YKL - 40可作为良好侧支循环发育和高SYNTAX评分的预测指标。
