Tan Yuanfei, Ji Xiaoying, Mo Zhifeng, Zhou Yaoliang
The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Medicine (Baltimore). 2019 Nov;98(47):e17950. doi: 10.1097/MD.0000000000017950.
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).
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.
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).
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.
探讨YKL-40在ST段抬高型心肌梗死（STEMI）中的作用及其与C反应蛋白（CRP）和基质金属蛋白酶-9（MMP-9）的关系。
这项前瞻性研究纳入了2014年4月至2017年12月期间被送至我院急诊科的358例STEMI患者。使用市售酶联免疫吸附测定（ELISA）试剂盒测定血清中YKL-40、CRP和MMP-9的水平。分析主要不良心血管事件（MACE）和总生存时间。
与存活患者相比，死亡患者的GRACE评分（P<0.001）以及YKL-40（P<0.001）、MMP-9（P<0.001）和CRP（P<0.001）水平显著更高。高YKL-40组的CRP（P=0.007）和MMP-9（P=0.022）水平也显著更高。GRACE评分也显著升高（P=0.011，95%CI 2.1（-9.7至-1.3））。高YKL-40组的累积MACE发生率和心源性死亡率显著更高（P<0.001，95%CI 3.9（1.9-8.2））。YKL-40水平较低的患者总生存时间显著更长（P<0.0001）。
YKL-40水平升高与CRP和MMP-9水平呈正相关，并与STEMI患者的临床结局相关，包括MACE和6个月生存率。
