# Prognostic utility of Wnt/β-catenin signaling pathway biomarkers in predicting outcomes of patients with ST-segment elevation myocardial infarction

## TL;DR

This study explores how Wnt/β-catenin pathway biomarkers can predict outcomes in patients with a severe heart attack called STEMI.

## Contribution

The study identifies β-catenin and DKK1 as strong predictors of adverse outcomes in STEMI patients.

## Key findings

- Elevated Wnt1, β-catenin, Wnt5a, and DKK1 levels correlate with higher MACE incidence in STEMI patients.
- High SFRP5 levels are associated with lower MACE incidence in STEMI patients.
- A combined model of β-catenin and DKK1 shows strong predictive performance (AUC = 0.946).

## Abstract

To investigate the expression profiles of Wnt/β-catenin signaling pathway–related biomarkers in patients with ST-segment elevation myocardial infarction (STEMI) and to evaluate their predictive value for major adverse cardiovascular events (MACE).

A total of 200 STEMI patients admitted to the emergency department between August 2021 and August 2024 were enrolled. Peripheral venous blood samples were collected immediately before emergency percutaneous coronary intervention (PCI) and serum levels of Wnt1, β-catenin, Wnt5a, secreted frizzled-related protein 5 (SFRP5), and Dickkopf-related protein 1 (DKK1) were measured using enzyme-linked immunosorbent assay. Based on the occurrence of MACE during hospitalization and within 1-year follow-up, patients were categorized into the MACE group (n = 29) and non-MACE group (n = 171). Kaplan–Meier survival analysis was used to assess differences in prognosis among patients with different biomarker levels. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify independent risk factors for MACE.

Serum levels of Wnt1, β-catenin, Wnt5a, and DKK1 were elevated, whereas SFRP5 was markedly reduced in the MACE group. Patients with high serum levels of Wnt1, β-catenin, Wnt5a, or DKK1 had significantly higher MACE incidence rates, while those with high SFRP5 levels had a lower incidence. β-catenin, DKK1, and cardiac troponin I (cTnI) were identified as independent risk factors for MACE in STEMI patients. The combined prediction model of β-catenin and DKK1 (AUC = 0.946; 95% CI = 0.910–0.981) showed superior predictive performance compared with single biomarkers.

The combined detection of β-catenin and DKK1 may serve as a potential biomarker for risk stratification in STEMI patients.