This indicates a role of YKL-40 in an ongoing protective process along with the pathological process [28] and could reason our finding, that a doubling in serum YKL-40 or 4th quartile YKL-40 values were independently associated with a 23 (9–35)% respectively 39 (15–56)% decreased risk of first-time IHD. This evidence concerns the gene CHI3L1 and myocardial ischemia.