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  • Schroder, JakobDepartment of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark (author)

Prognosis And Reclassification By YKL-40 In Stable Coronary Artery Disease

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • 2020
  • electronicrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:uu-405996
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-405996URI
  • https://doi.org/10.1161/JAHA.119.014634DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:143506728URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:du-32335URI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

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  • BackgroundThe inflammatory biomarker YKL‐40 has previously been studied as a potential risk marker in cardiovascular disease. We aimed to assess the prognostic reclassification potential of serum YKL‐40 in patients with stable coronary artery disease.Methods and ResultsThe main study population was the placebo group of the CLARICOR (Effect of Clarithromycin on Mortality and Morbidity in Patients With Ischemic Heart Disease) trial. The primary outcome was a composite of acute myocardial infarction, unstable angina pectoris, cerebrovascular disease, and all‐cause mortality. We used Cox proportional hazards regression models adjusted for C‐reactive protein level and baseline cardiovascular risk factors. Improvement in prediction by adding serum YKL‐40 to the risk factors was calculated using the Cox‐Breslow method and c‐statistic. A total of 2200 patients were randomized to placebo, with a follow‐up duration of 10 years. YKL‐40 was associated with an increased risk of the composite outcome (hazard ratio per unit increase in (YKL‐40) 1.13, 95% CI 1.03–1.24, P=0.013) and all‐cause mortality (hazard ratio 1.32, 95% CI 1.17–1.49, P<0.0001). Considering whether a composite‐outcome event was more likely to have, or not have, occurred to date, we found 68.4% of such predictions to be correct when based on the standard predictors, and 68.5% when serum YKL‐40 was added as a predictor. Equivalent results were obtained with c‐statistics.ConclusionsHigher serum YKL‐40 was independently associated with an increased risk of adverse cardiovascular outcomes and mortality. Addition of YKL‐40 did not improve risk prediction in patients with stable coronary artery disease.

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  • Jakobsen, Janus ChristianCopenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark;Department of Cardiology, Holbæk Hospital, Holbæk, Denmark;Department of Regional Health Research, The Faculty of Heath Sciences, University of Southern Denmark, Odense, Denmark (author)
  • Winkel, PerCopenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (author)
  • Hilden, JørgenSection of Biostatistics, Department of Public Health Research, University of Copenhagen, Copenhagen, Denmark (author)
  • Jensen, Gorm BojeDepartment of Cardiology, Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark (author)
  • Sajadieh, AhmadDepartment of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark (author)
  • Larsson, AndersUppsala universitet,Klinisk kemi(Swepub:uu)andlarss (author)
  • Ärnlöv, Johan,1970-Högskolan Dalarna,Karolinska Institutet,Medicinsk vetenskap,Karolinska institutet(Swepub:du)jan (author)
  • Harutyunyan, MarinaDepartment of Cardiology, Rigshospitalet, University of Copenhagen, København, Denmark (author)
  • Johansen, Julia S.Department of Medicine, Herlev and Gentofte Hospital, Copenhagen, Denmark (author)
  • Kjøller, ErikCopenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark;Department of Cardiology S, Herlev Hospital University of Copenhagen, Denmark (author)
  • Gluud, ChristianCopenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (author)
  • Kastrup, JensDepartment of Cardiology, Rigshospitalet, University of Copenhagen, København, Denmark (author)
  • Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, DenmarkCopenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark;Department of Cardiology, Holbæk Hospital, Holbæk, Denmark;Department of Regional Health Research, The Faculty of Heath Sciences, University of Southern Denmark, Odense, Denmark (creator_code:org_t)

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  • In:Journal of the American Heart Association9:52047-9980

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