Author + information
- Received January 23, 2006
- Revision received March 7, 2006
- Accepted March 15, 2006
- Published online June 6, 2006.
- Akira Sato, MD⁎,
- Kazutaka Aonuma, MD†,
- Kyoko Imanaka-Yoshida, MD‡,⁎ (, )
- Toshimichi Yoshida, MD‡,
- Mitsuaki Isobe, MD§,
- Daisuke Kawase∥,
- Noriaki Kinoshita, PhD∥,
- Yoshio Yazaki, MD¶ and
- Michiaki Hiroe, MD#
- ↵⁎Reprint requests and correspondence:
Dr. Kyoko Imanaka-Yoshida, Department of Pathology and Matrix Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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 (≥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.
Supported by a grant-in-aid for scientific research (no. 15590735) from the Ministry of Education, Culture, Sports, Science and Technology, Japan, to Dr. Imanaka-Yoshida, and a grant for intractable disease from the Ministry of Health, Labor and Welfare, Japan, to Dr. Hiroe. Mr. Kawase and Dr. Kinoshita are employees of IBL Co., which is the commercial source of the tenascin-C antibody and tenascin-C assay ELISA kit.
- Received January 23, 2006.
- Revision received March 7, 2006.
- Accepted March 15, 2006.
- American College of Cardiology Foundation