Abstract 15383: Elevated Plasma YKL-40 Levels and Ischemic Stroke in the General Population
Background: We hypothesized that elevated plasma YKL-40 levels associate with increased risk of ischemic cardiovascular disease in the general population. In contrast to C-reactive protein (CRP) produced in the liver in response to inflammation, YKL-40 is produced by lipid-laden macrophages inside the vessel wall.
Methods and Results: We measured plasma YKL-40 in 8,899 participants of The Copenhagen City Heart Study 1991–1994 examination, and followed them until 2009. Endpoints were ischemic stroke, ischemic cerebrovascular disease, myocardial infarction, and ischemic heart disease. Hazard ratios were calculated for plasma YKL-40 levels in 10 years age percentile categories of 34–66%, 67–90% and 91–100% vs. 0–33%. Multifactorially and CRP adjusted hazard ratios for ischemic stroke were 1.2 (95% CI, 0.9–1.6), 1.8 (1.3–2.4), and 2.3 (1.5–3.3) for these YKL-40 categories, respectively (p-trend<0.001). Corresponding hazard ratios for ischemic cerebrovascular disease were 1.2 (0.9–1.5), 1.6 (1.2–2.0) and 2.2 (1.6–3.1) (p-trend<0.001). Hazard ratios for myocardial infarction were not significant, while corresponding hazard ratios for ischemic heart disease were 1.0 (0.8–1.2), 1.2 (1.0–1.5) and 1.3 (1.0–1.7) (p-trend=0.008). Stratifying for CRP or other risk factors gave similar results. A doubling in plasma YKL-40 was associated with multifactorially and CRP adjusted increased risk for ischemic stroke, ischemic cerebrovascular disease, myocardial infarction and ischemic heart disease of 20% (95% CI, 11%–30%), 16% (8%–24%), 3%(−5%–11%) and 7% (1%–12%), respectively.
Conclusions: In the general population, elevated plasma YKL-40 levels are associated with increased risk of ischemic stroke and ischemic cerebrovascular disease, independent of plasma CRP levels.
- © 2010 by American Heart Association, Inc.