Plasma YKL-40 Elevation on Admission and Follow-Up Is Associated with Diastolic Dysfunction and Mortality in Patients with Acute Myocardial Infarction

Objective. The aim of the study was to determine an association between the plasma YKL-40 level and echocardiographic left ventricle systolic and diastolic function parameters in patients with acute myocardial infarction. Subjects and Methods. The study included 46 patients with acute myocardial infarction. Serum brain natriuretic protein (BNP) and YKL-40 levels were analyzed on admission and after one month. Left ventricle systolic and diastolic functions and Tei index were computed by transthoracic echocardiography. Results. Plasma YKL-40 was significantly higher in patients with acute myocardial infarction (AMI) (101.7 μg/L versus 34 μg/L, resp., p<0.001) and remained higher than in healthy subjects after one month. The levels of YKL-40 on admission were correlated with log BNP on admission (r=0.41,p=0.004), Tei index (r=0.44,p=0.002), left atrium volume index (r=0.32,p=0.02), and mitral septal annular E/e′ (r=0.44,p=0.003). Death was more frequently observed in patients with plasma YKL-40 above the median value than in those with plasma YKL-40 below the median value (p=0.001; OR = 13.6 (2.5–72.3)). Conclusion. YKL-40 elevations in patients with AMI remain at least one month and are associated with serum BNP elevations, diastolic dysfunction, and long-term increased overall mortality. It has prognostic importance in patients with AMI

The association of uncarboxylated matrix gla protein with mitral annular calcification in patients without significant coronary artery disease

Objective: Mitral annular calcification (MAC) is associated with systemic calcification and cardiovascular disease (CVD) events. Matrix Gla protein (MGP) is a strong inhibitor of vascular and soft-tissue calcification and reduced levels of its circulating precursor, uncarboxylated MGP (ucMGP), was found associated with vascular calcification in pilot studies. Methods and Results: In this study, which includes 86 outpatients with no significant coronary artery and chronic kidney diseases, we measured serum ucMGP levels and evaluated MAC using echocardiography. In participants with MAC (n = 44), serum ucMGP levels were lower than the control group (n = 42) (216.1 ± 154.1 vs. 390.2 ± 256.3, P = 0.001, respectively). The patients with MAC were divided into two groups: mild MAC group and moderate MAC group. Serum ucMGP levels were significantly lower in the moderate MAC group than the mild MAC group (139.0 ± 121.8 vs. 248.4 ± 156.3, P = 0.03, respectively). Conclusions: In patients with MAC, serum ucMGP level was significantly low, and this association has been detected for the first time in patients with no significant coronary artery disease (CAD)