S twice that of the upper level of normal or cardiac troponin I (cTnI) level 0.1 ng/ml, both with persistent electrocardiographic ST segment elevation .1 mm in 2 or more contiguous leads or newly occurred left bundle branch block. NSTE-ACS included non-STEMI (NSTEMI) and unstable angina (UA). The diagnosis of NSTEMI was angina or discomfort at rest with ST segment depression or transient elevation and/or prominent T-wave inversion, with cardiac enzyme levels twice that of the upper level of normal or cTnI 0.1 ng/ml. Patients with clinical features and/or electrocardiographic TA-02 site expression of NSTEMI but normal cardiac biomarker levels were diagnosed as having UA. The study protocol was approved by the Clinical Research Ethic Committee of Qilu Hospital, Medical Colledge of Shandong University. The study was in accordance with principles of Helsinki Declaration and all patients provided written informed consent.Statistical AnalysisAll data were analyzed by use of SPSS v16.0 (SPSS Inc., Chicago, IL, USA). Numeric variables are expressed as mean6SD. Categorical variables are expressed as frequencies and percentages. Kolmogorov-Smirnov test was used to assess normal distribution of quantitative variables, with log transformation for non-normal distribution. Categorical data were compared by chi-square test or Fisher’s exact test as appropriate. Bivariate correlation was used for correlation analysis. One-way ANOVA was used for comparison of multiple groups [15]. Binary logistic regression was used to assess the independent association of DKK1 level with MACE. Differences in the predictive values were estimated by comparing the area under the receiver-operating characteristic curve (ROC). The level of statistical significance was set at P,0.05.Results Baseline Characteristics of Study SubjectsA total of 331 patients with ACS met the inclusion criteria, and we had complete data for 322. At the end of the study, data for 291 patients (193 males, 66.3 ) with complete follow-up data were analyzed, including 46 with STEMI and 245 with NSTEACS (63 with NSTEMI, 182 with UA), and 68 of our patients underwent percutaneous coronary intervention. The flow chart of data in the study is presented in Figure 1. The demographic and clinical characteristics of patients grouped by tertiles of baseline DKK-1 level are in Table 1. All data were obtained within 24 hr after admission. Patients with high DKK-1 levels were older and had higher blood glucose and hs-CRP concentrations than others. DKK-1 level did not differ by coronary artery status.Laboratory AnalysisBlood samples were collected in EDTA-containing tubes and then centrifuged at 4uC. The collected plasma was stored in aliquots at 280uC. DKK-1 concentration was 1485-00-3 measured by use of an ELISA kit (R D Systems, Minneapolis, USA). All laboratory data, including total cholesterol (TC), triglycerides (TG), highdensity lipoprotein-cholesterol (HDL-C), low-density lipoproteincholesterol (LDL-C), blood glucose, uric acid level, creatinine level, creatinine kinase activity, and cTnI and hs-CRP levels were measured in the biochemical department of Qilu Hospital.Calculation of GRACE Risk ScoresThe main principle of the GRACE risk score has been described elsewhere [13]. The variables required for calculation of the score include age, heart rate, systolic blood pressure, baseline creatinine level, history of congestive heart failure, inhospital percutaneous coronary intervention, history of MI, STsegment depression on.S twice that of the upper level of normal or cardiac troponin I (cTnI) level 0.1 ng/ml, both with persistent electrocardiographic ST segment elevation .1 mm in 2 or more contiguous leads or newly occurred left bundle branch block. NSTE-ACS included non-STEMI (NSTEMI) and unstable angina (UA). The diagnosis of NSTEMI was angina or discomfort at rest with ST segment depression or transient elevation and/or prominent T-wave inversion, with cardiac enzyme levels twice that of the upper level of normal or cTnI 0.1 ng/ml. Patients with clinical features and/or electrocardiographic expression of NSTEMI but normal cardiac biomarker levels were diagnosed as having UA. The study protocol was approved by the Clinical Research Ethic Committee of Qilu Hospital, Medical Colledge of Shandong University. The study was in accordance with principles of Helsinki Declaration and all patients provided written informed consent.Statistical AnalysisAll data were analyzed by use of SPSS v16.0 (SPSS Inc., Chicago, IL, USA). Numeric variables are expressed as mean6SD. Categorical variables are expressed as frequencies and percentages. Kolmogorov-Smirnov test was used to assess normal distribution of quantitative variables, with log transformation for non-normal distribution. Categorical data were compared by chi-square test or Fisher’s exact test as appropriate. Bivariate correlation was used for correlation analysis. One-way ANOVA was used for comparison of multiple groups [15]. Binary logistic regression was used to assess the independent association of DKK1 level with MACE. Differences in the predictive values were estimated by comparing the area under the receiver-operating characteristic curve (ROC). The level of statistical significance was set at P,0.05.Results Baseline Characteristics of Study SubjectsA total of 331 patients with ACS met the inclusion criteria, and we had complete data for 322. At the end of the study, data for 291 patients (193 males, 66.3 ) with complete follow-up data were analyzed, including 46 with STEMI and 245 with NSTEACS (63 with NSTEMI, 182 with UA), and 68 of our patients underwent percutaneous coronary intervention. The flow chart of data in the study is presented in Figure 1. The demographic and clinical characteristics of patients grouped by tertiles of baseline DKK-1 level are in Table 1. All data were obtained within 24 hr after admission. Patients with high DKK-1 levels were older and had higher blood glucose and hs-CRP concentrations than others. DKK-1 level did not differ by coronary artery status.Laboratory AnalysisBlood samples were collected in EDTA-containing tubes and then centrifuged at 4uC. The collected plasma was stored in aliquots at 280uC. DKK-1 concentration was measured by use of an ELISA kit (R D Systems, Minneapolis, USA). All laboratory data, including total cholesterol (TC), triglycerides (TG), highdensity lipoprotein-cholesterol (HDL-C), low-density lipoproteincholesterol (LDL-C), blood glucose, uric acid level, creatinine level, creatinine kinase activity, and cTnI and hs-CRP levels were measured in the biochemical department of Qilu Hospital.Calculation of GRACE Risk ScoresThe main principle of the GRACE risk score has been described elsewhere [13]. The variables required for calculation of the score include age, heart rate, systolic blood pressure, baseline creatinine level, history of congestive heart failure, inhospital percutaneous coronary intervention, history of MI, STsegment depression on.
