Serum tenascin-C might be a novel predictor of left ventricular remodeling and prognosis after acute myocardial infarction.

Abstract

OBJECTIVES:

We investigated clinical implications of serum tenascin-C (TN-C) levels in patients with acute myocardial infarction (AMI).

BACKGROUND:

Tenascin-C, an extracellular matrix glycoprotein, is not normally expressed in the adult heart, but transiently appears during pathological conditions and plays important roles in tissue remodeling.

METHODS:

Serum TN-C levels were measured by ELISA in 105 AMI patients at various time points, in 10 old myocardial infarction (OMI) patients, and 20 normal controls.

RESULTS:

The mean serum TN-C level of AMI patients on admission (63.3 +/- 30.1 ng/ml) was significantly higher than that of controls and OMI (30.9 +/- 8.8 ng/ml and 27.4 +/- 11.7 ng/ml, respectively, p < 0.01), and peaked at 5 days (83.2 +/- 43.0 ng/ml). Follow-up examination (mean: 43.9 +/- 19.6 months) revealed that 25 of 105 AMI (23.8%) patients showed left ventricular (LV) remodeling (> or =20% end-diastolic volume increase), and in 15 (14.3%), major adverse cardiac events (MACE) were detected. The peak TN-C level was significantly higher in the remodeling group than the nonremodeling group (112 +/- 37 ng/ml vs. 66 +/- 29 ng/ml; p < 0.0001). By receiver-operating characteristic (ROC) analysis, TN-C levels clearly discriminated prediction of LV remodeling and MACE compared with other variables including plasma B-type natriuretic peptide, creatine kinase-MB, and LV function. Best predictive values of TN-C for remodeling and MACE were 84.8 and 92.8 ng/ml, respectively. Cox proportional hazards model analysis showed that TN-C was an important independent predictor of MACE.

CONCLUSIONS:

The findings suggest that serum TN-C levels might be useful in predicting LV remodeling and prognosis after AMI.

• Authors: Akira Sato, Kazutaka Aonuma, Kyoko Imanaka-Yoshida, Toshimichi Yoshida, Mitsuaki Isobe, Daisuke Kawase, Noriaki Kinoshita, Yoshio Yazaki, Michiaki Hiroe
• Journal: Journal of the American College of Cardiology (J Am Coll Cardiol) Vol. 47 Issue 11 Pg. 2319-25 (Jun 06 2006) ISSN: 1558-3597 [Electronic] United States
• PMID: 16750702 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Tenascin

Topics

• Aged
• Case-Control Studies
• Enzyme-Linked Immunosorbent Assay
• Female
• Heart Diseases (etiology, physiopathology)
• Humans
• Immunohistochemistry
• Male
• Middle Aged
• Myocardial Infarction (blood, complications, physiopathology)
• Myocardium (metabolism)
• Osmolar Concentration
• Predictive Value of Tests
• Prognosis
• Prospective Studies
• ROC Curve
• Severity of Illness Index
• Survival Analysis
• Tenascin (blood, metabolism)
• Ventricular Remodeling