Dkk-1 (Dickkopf-1) level at admission predicts cardiovascular and major bleeding outcomes in patients with acute myocardial infarction

There has been no evidence about the prognostic significance of Dkk-1 (dickkopf-1) for ischemic cardiovascular and bleeding events in patients with myocardial infarction (MI). We aim to evaluate the prognostic effect of Dkk-1 at admission on 12-month risk of cardiovascular and bleeding outcomes in MI. Here we measured plasma Dkk-1 level centrally in 1364 MI patients from BIPass (BIomarker-based Prognostic Assessment for patients with Stable angina and acute coronary Syndromes) study. Dkk-1 was significantly associated with the increased risk of the composite of cardiac death, MI, and ischemic stroke (HR 1.37, 95% CI: 1.13 -1.66, p = 0.001), and major bleeding (HR 1.81, 95% CI:1.13 - 2.90, p = 0.013) after adjusting for clinical risk factors and prognostic biomarkers (hs-cTnT, NT-proBNP, and cystatin C). We first report that Dkk-1 at admission could predict cardiovascular events and major bleeding during 12-month follow-up after MI.Trial registration: clinicaltrials.gov Identifier: NCT04044066.