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GW23-e2033
DICKKOPF-1 (DKK1) AS A NOVEL BIOMARKER IS ASSOCIATED WITH RISK STRATIFICATION BY GRACE RISK SCORE FOR PREDICTIVE VALUE IN PATIENTS WITH ACUTE CORONARY SYNDROME
  1. Lin Wang,
  2. Xiao Bo Hu,
  3. Wei Zhang,
  4. Lin Di Wu,
  5. Ji Fu Li,
  6. Wen Qiang Chen,
  7. Yun Zhang,
  8. Mei Zhang,
  9. Mei Zhang
  1. Qilu Hospital of Shandong University

    Abstract

    Objectives DKK-1, a major regulator of the wingless (Wnt) pathway, turns out to play role in cardiovascular disease. The knowledge of relationship between DKK-1 and ACS is limited, and we also want to find whether the predictive value of post-discharge GRACE risk score can be improved by adding DKK-1.

    Methods 291 patients admitted in our cardiovascular department from March 2008 to January 2010 were enrolled (46 with STEMI and 245 with NSTE-ACS) in the study. All the clinical data were collected by a specific physician. The plasma DKK-1 concentrations were measured using ELISA (R&D) strictly according to the manufacturer's protocol. We calculated the post-discharge GRACE score and assessed the prognostic value alone and together with DKK-1 or hs-CRP.

    Results After a median follow-up of 2 years, 40 patients had major adverse cardiac event. DKK-1 was significantly higher in STEMI patients compared with NSTE-ACS patients in baseline (p=0.006). The concentration of DKK-1 was higher in the high risk category of GRACE score than the intermediate and low groups (p=0.006 and p<0.001). There was no significant difference between the intermediate and low groups (p=0.099). The event group also had higher DKK-1 concentration compared with non-event group (p<0.001). DKK-1 concentration was correlated with hs-CRP (r=0.295, p<0.001). The GRACE score provided a c-statistic regarding MACE of 0.523. The c-statistic was improved to 0.782 after addition of hs-CRP, 0.768 for DKK-1 and 0.834 when both two biomarkers were added.

    Conclusions DKK-1 is an independent predictor for long-term MACE of ACS patients. The long-term predictive ability of post-discharge GRACE score is enhanced by the addition of DKK-1.

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