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- Title
Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary disease.
- Authors
Holmgaard, Dennis B.; Mygind, Lone H.; Titlestad, Ingrid L.; Madsen, Hanne; Pedersen, Svend Stenvang; Johansen, Julia S.; Pedersen, Court
- Abstract
Background Chronic obstructive pulmonary disease (COPD) is hallmarked by inflammatory processes and a progressive decline of lung function. YKL-40 is a potential biomarker of inflammation and mortality in patients suffering from inflammatory lung disease, but its prognostic value in patients with COPD remains unknown. We investigated whether high plasma YKL-40 was associated with increased mortality in patients with moderate to very severe COPD. Methods Four hundred and ninety-three patients with moderate to very severe COPD were followed prospectively for up to 10 years. Patients were divided into two groups according to plasma YKL-40: concentration higher than the 75th percentile for age-matched healthy subjects (i.e. high levels) and normal levels. Outcome was overall survival (OS) and was evaluated in uniand multivariate proportional hazards Cox regression analyses and adjusted for factors affecting mortality. Results Median plasma YKL-40 was increased in patients with COPD (81 ng/ml, p < 0.001) compared to healthy subjects (40 ng/ml). Patients with high plasma YKL-40 had a hazard ratio (HR) of 1.42 (95% CI: 1.15-1.75, p = 0.001) for all-cause mortality. Multivariate analysis showed that YKL-40 (HR 1.38; 95% CI: 1.11-1.72, p = 0.004), age (HR 1.05; 95% CI: 1.03-1.06, p < 0.0001), Severe COPD (HR 1.35; 95 CI: 1.03-1.76, p = 0.03) very severe COPD (HR 2.19; 95% CI: 1.60 - 2.99 < 0.0001), neutrophil granulocyte count (HR 1.05; 95% CI: 1.01-1.08, p = 0.01), and a smoking history of > 40 years (HR 1.38; 95% CI: 1.11- 1.71, p = 0.003) were independent prognostic markers of OS. Conclusion High plasmaYKL-40 is associated with increased mortality in patients with moderate to very severe COPD, suggesting a role for YKL-40 as a potential biomarker of mortality in this patient group.
- Subjects
OBSTRUCTIVE lung diseases patients; BIOMARKERS; PNEUMONIA; NEUTROPHILS; GRANULOCYTES; MULTIVARIATE analysis
- Publication
BMC Pulmonary Medicine, 2013, Vol 13, Issue 1, p1
- ISSN
1471-2466
- Publication type
Article
- DOI
10.1186/1471-2466-13-77