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Admission Levels of...
Admission Levels of DKK1 (Dickkopf-1) Are Associated With Future Cardiovascular Death in Patients With Acute Coronary Syndromes
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- Ueland, Thor (författare)
- Research Institute of Internal Medicine, National Hospital, University of Oslo, Norway ; K.G. Jebsen Inflammatory Research Center, University of Oslo, Norway ; K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Norway
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- Åkerblom, Axel, 1977- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Ghukasyan, Tatevik (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Michelsen, Annika E (författare)
- From the Research Institute of Internal Medicine, National Hospital, University of Oslo, Norway
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- Becker, Richard C (författare)
- Division of Cardiovascular Health and Disease, Heart, Lung and Vascular Institute, University of Cincinnati College of Medicine, Ohio, USA
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- Bertilsson, Maria (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Himmelmann, Anders (författare)
- AstraZeneca Research and Development, Gothenburg, Sweden
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- James, Stefan, 1964- (författare)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Siegbahn, Agneta, 1947- (författare)
- Uppsala universitet,Koagulation och inflammationsvetenskap,Uppsala kliniska forskningscentrum (UCR)
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- Storey, Robert F (författare)
- Department of Infection, Immunity, and Cardiovascular Disease, University of Sheffield, United Kingdom
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- Kontny, Frederic (författare)
- Department of Cardiology, Stavanger University Hospital, Norway ; Drammen Heart Center, Norway
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- Aukrust, Pål (författare)
- Research Institute of Internal Medicine, National Hospital, University of Oslo, Norway ; K.G. Jebsen Inflammatory Research Center, University of Oslo, Norway ; K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Norway ; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Norway
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- Wallentin, Lars, 1943- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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Research Institute of Internal Medicine, National Hospital, University of Oslo, Norway ; KG. Jebsen Inflammatory Research Center, University of Oslo, Norway ; K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Norway Uppsala kliniska forskningscentrum (UCR) (creator_code:org_t)
- 2019
- 2019
- Engelska.
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Ingår i: Arteriosclerosis, Thrombosis and Vascular Biology. - 1079-5642 .- 1524-4636. ; 39:2, s. 294-302
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective- The Wnt/wingless signaling antagonist DKK1 (dickkopf-1) regulates platelet-mediated inflammation and may contribute to plaque destabilization. We hypothesized that DKK1 would be associated with cardiovascular outcomes.Approach and Results- We determined DKK1 levels in serum samples obtained before randomization, at discharge, and 1 and 6 months in a subset of 5165 patients with acute coronary syndromes in the PLATO trial (Platelet Inhibition and Patient Outcomes; NCT00391872). The median (interquartile range) DKK1 concentrations were 0.61 (0.20-1.27) ng/mL at baseline and increased during follow-up. The hazard ratio (95% CIs) for the composite end point (cardiovascular death, nonprocedural spontaneous myocardial infarction, or stroke) during 1 year of follow-up, per 50% increase in baseline DKK1 concentration, was 1.06 (1.02-1.10), P=0.0011, and remained significant in fully adjusted analysis with 14 conventional clinical and demographic and 6 biochemical variables, including NT-proBNP (N-terminal pro-B-type natriuretic peptide), hs-TnT (high-sensitivity troponin T), and GDF-15 (growth differentiation factor 15; 1.05 [1.00-1.09]; P=0.028). This association was mainly driven by the association with cardiovascular death, where a gradual increase in event rates was observed with increasing quartiles of DKK1 (2.7%, 3.0%, 4.3%, and 5.0%) and remained significant and unmodified in fully adjusted analysis (hazard ratio, 1.10 [1.04-1.17]; P=0.002). Change in DKK1 and levels at 1 month were unrelated to outcomes. A modifying effect of ticagrelor on DKK1 discharge levels was observed but not associated with prognosis.Conclusions- In patients with acute coronary syndromes treated with dual antiplatelet treatment, admission DKK1 levels were independently associated with a composite of cardiovascular death, myocardial infarction, or stroke and with cardiovascular death alone.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- acute coronary syndrome
- blood platelets
- follow-up studies
- humans
- stroke
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- Av författaren/redakt...
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Ueland, Thor
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Åkerblom, Axel, ...
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Ghukasyan, Tatev ...
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Michelsen, Annik ...
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Becker, Richard ...
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Bertilsson, Mari ...
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Himmelmann, Ande ...
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James, Stefan, 1 ...
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Siegbahn, Agneta ...
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Storey, Robert F
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Kontny, Frederic
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Aukrust, Pål
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Wallentin, Lars, ...
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- MEDICIN OCH HÄLSOVETENSKAP
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Arteriosclerosis ...
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