title: Serum tenascin-C might be a novel predictor of left ventricular remodeling and prognosis after acute myocardial infarction.
abstract: OBJECTIVE
  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.affiliation: Department of Cardiology, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Aonuma
authors.forename: Kyoko
authors.initials: K
authors.lastname: Imanaka-Yoshida
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Isobe
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kawase
authors.forename: Noriaki
authors.initials: N
authors.lastname: Kinoshita
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yazaki
authors.forename: Michiaki
authors.initials: M
authors.lastname: Hiroe
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006331:Heart Diseases / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D009206:Myocardium / Q000378:metabolism; D009994:Osmolar Concentration; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D016019:Survival Analysis; D019063:Tenascin / Q000097:blood* / Q000378:metabolism; D020257:Ventricular Remodeling
chemical_list: D019063:Tenascin