Abstract 14183: Effectiveness of Serum Tenascin-C Level in Predicting Long-term Prognosis After Acute Myocardial Infarction Treated With Successful Percutaneous Coronary Intervention
Background: Tenascin-C (TN-C), an extracellular matrix glycoprotein sparsely detected in healthy adult heart but that is expressed in the pathological myocardium under various pathological conditions, is closely associated with inflammation and tissue remodeling. Recently, we reported that patients with high serum levels of TN-C after acute myocardial infarction (AMI) have a greater incidence of ventricular remodeling. We evaluated the predictive value of serum TN-C and plasma B-type natriuretic peptide (BNP) levels as a combined prognostic biomarker after AMI treated with successful percutaneous coronary intervention (PCI).
Methods: We assessed 239 patients with ST-segment elevation MI who underwent sucessful PCI. We measured serum TN-C and plasma BNP levels on day 5 after admission and compared long-term clinical outcome.
Results: During the follow-up period (24 ± 13 months), 23 patients died of cardiac events. Age, serum peak creatine kinase-MB, serum TN-C, and plasma BNP were significantly higher in the patients who died. Multivariate analysis revealed serum TN-C and plasma BNP levels to be independent predictors of cardiac death. In particular, cardiac death was predicted with TN-C best value of 122 ng/ml (AUC 0.791) and BNP best value of 371 pg/ml (AUC 0.761) by ROC analysis. Kaplan-Meier analysis showed cardiac deaths were more frequently observed in the group with TN-C ≥122 ng/ml and BNP ≥371 pg/ml (p <0.0001). Consideration of both TN-C and BNP further improved risk stratification (Figure).
Conclusions: The combined index of serum TN-C and plasma BNP levels on day 5 after admission is potentially useful for early risk stratification after AMI.
- © 2010 by American Heart Association, Inc.