Serum tenascin-C might be a novel predictor of left ventricular remodeling and prognosis after acute myocardial infarction.
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.
Sato
Akira
A
Department of Cardiology, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Aonuma
Kazutaka
K
Imanaka-Yoshida
Kyoko
K
Yoshida
Toshimichi
T
Isobe
Mitsuaki
M
Kawase
Daisuke
D
Kinoshita
Noriaki
N
Yazaki
Yoshio
Y
Hiroe
Michiaki
M
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
D019063:Tenascin