Evaluation of serum YKL-40 level among clinical risk scores for early mortality in acute pulmonary thromboembolism

Clin Biochem. 2022 Oct:108:20-26. doi: 10.1016/j.clinbiochem.2022.07.003. Epub 2022 Jul 16.

Abstract

Introduction: Pulmonary embolism (PE) often occurs secondary to deep vein thrombosis and is an important cause of mortality and morbidity. This study aimed to evaluate the relationship between YKL-40 level and clinical risk score in patients with PE.

Methods: The study included a total of 100 patients, 80 patients diagnosed with PE in the emergency department and 20 healthy controls. Patients with PE were divided into four groups: high-risk patients (n = 20), high-intermediate-risk patients (n = 20), low-intermediate-risk patients (n = 20), and low-risk patients (n = 20). Serum YKL-40 levels were measured by enzyme-linked immunosorbent assay. Pulmonary artery obstruction index (PAOI) was calculated from computed tomography angiography images.

Results: PAOI increased in correlation with PE risk and differed significantly between all patient groups (p < 0.001). Troponin-I levels were significantly higher in the high-risk and high-intermediate-risk groups compared to the other groups (p < 0.001), but did not differ significantly between high-risk and high-intermediate-risk patients (p = 0.09). YKL-40 level was significantly higher in the high-risk PE group than the high-intermediate-risk group (p < 0.001). In receiving operator characteristic curve analysis assessing the discriminatory value of YKL-40 for high-risk PE patients, a cut-off value of 227.2 ng/mL had sensitivity of 85 % and specificity of 70 %.

Discussion: YKL-40 may be an important biomarker in decisions regarding early thrombolytic treatment in patients with high-intermediate-risk PE. In addition, medical treatments targeting YKL-40 may also reduce thrombotic tendency in high-risk patient groups.

Keywords: Clinical severity; Pulmonary embolism; YKL-40.

MeSH terms

  • Acute Disease
  • Arterial Occlusive Diseases*
  • Biomarkers
  • Chitinase-3-Like Protein 1
  • Humans
  • Pulmonary Embolism* / diagnosis
  • Risk Factors
  • Troponin I

Substances

  • Biomarkers
  • CHI3L1 protein, human
  • Chitinase-3-Like Protein 1
  • Troponin I