Serum Tenascin-C Might Be a Novel Predictor of Left Ventricular Remodeling and Prognosis After Acute Myocardial Infarction

ObjectivesWe investigated clinical implications of serum tenascin-C (TN-C) levels in patients with acute myocardial infarction (AMI).BackgroundTenascin-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.MethodsSerum 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.ResultsThe 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 (≥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.ConclusionsThe findings suggest that serum TN-C levels might be useful in predicting LV remodeling and prognosis after AMI