Plasma YKL-40 and recovery of left ventricular function after acute myocardial infarction

Area of Science:

• Cardiology
• Biomarkers
• Myocardial Infarction Research

Background:

• Plasma YKL-40 levels are elevated early in ST-elevation myocardial infarction (STEMI) patients.
• The relationship between YKL-40, infarct size, and ventricular function recovery post-primary percutaneous coronary intervention (PCI) remains unclear.
• The influence of granulocyte colony-stimulating factor (G-CSF) therapy on plasma YKL-40 concentrations in STEMI patients is unknown.

Purpose of the Study:

• To investigate the association between plasma YKL-40 and infarct size and left ventricular ejection fraction (LVEF) recovery after primary PCI in STEMI patients.
• To determine if G-CSF therapy affects plasma YKL-40 levels in STEMI patients.

Main Methods:

• A double-blind, randomized, placebo-controlled trial involving 72 STEMI patients treated with PCI.
• Patients received subcutaneous G-CSF or placebo injections from day 1 to 7 post-STEMI.
• Plasma YKL-40, hs-CRP, and CK-MB were measured serially; infarct size and LVEF were assessed by MRI at baseline and 6 months.

Main Results:

• Baseline plasma YKL-40 was significantly higher in STEMI patients compared to healthy subjects (92 vs 34 microg/L).
• In the placebo group, YKL-40 correlated with hs-CRP and negatively with LVEF recovery, but not infarct size.
• G-CSF treatment increased YKL-40 compared to placebo but did not influence infarct size or LVEF recovery.

Conclusions:

• Plasma YKL-40 is significantly elevated in STEMI patients upon admission.
• G-CSF therapy further increases YKL-40 levels.
• Plasma YKL-40 may serve as an indirect marker of LVEF recovery, with higher levels suggesting poorer recovery, independent of hs-CRP.