Value of serum tenascin-C in patients with acute myocardial infarction

Abstract

Background: Myocardial infarction (MI) is defined as myocardial cell necrosis due to significant and sustained ischemia. TN-C is an extracellular matrix glycoprotein that is expressed in several important steps during the very early stage of cardiogenesis. TN-C is not normally expressed in the adult heart, but transiently appears during pathological conditions and plays important roles in tissue remodeling. Aim: To study the role of TN-C in myocardial infarction patients and to evaluate its role as a predictor of HF in these patients. Methods: This study was conducted on 45 cases uniformly divided into 3 closely matched (in age and sex) groups as follows: Group (I) includes 15 patients who were suffering from AMI; Group (II) includes 15 patients who were suffering from HF on top of MI; and Group (III) includes 15 healthy volunteers coming for regular annual checkup. 3-6 ml venous blood was collected on the day of admission under complete aseptic conditions and stored at À70°C until assayed by ELISA. Results: TN-C levels in the sera of patients with AMI Group (I) were significantly higher than those of healthy volunteers. Moreover, in Group I of AMI, a positive correlation between TN-C level on one side and CK, CK-MB and troponin T level on the other side was found. TN-C levels in the sera of patients with congestive heart failure on top of acute MI Group (II) were significantly higher than those of healthy volunteers. Pro-BNP levels in patients with heart failure Group (II) were significantly higher than those with AMI not complicated with heart failure Group (I). Levels of pro-BNP were also positively correlated with those of TN-C in patients with heart failure on top of AMI Group (II). Conclusions: Serum TN-C might be a novel marker reflecting active structural remodeling in the myocardium following infarction, with high TN-C levels at acute stages possibly predicting progression of LV remodeling. Also, the incorporation of a combination of serum TN-C and plasma BNP levels may improve risk stratification for congestive heart failure after AMI. Further studies on large scale are needed for more evaluation of TN-C role in HF.

Role of Tenascin-C as a Predictor of Left Ventricular Remodeling after Streptokinase in Patients with Acute Myocardial Infarction

“…The study included 45 cases; 15 patients with AMI, 15 patients with heart failure on top of MI and 15 normal controls. Venous blood samples were taken on day of admission [16].…”

A model for prognosis of development of left ventricular systolic dysfunction in patients with acute myocardial infarction and type 2 diabetes mellitus taking into account tenascin C level

“…У дослідженні [9] проаналізовані випадки повторної госпіталізації у зв'язку з погіршенням серцевої недостатності та смертністю впродовж року. Результати свідчать: рівень тенасцину C у хворих із серцевою недостатністю був вищим у порівнянні з контрольною групою.…”

“…Нині доведено, що вміст тенасцину С підвищується у хворих на гострий інфаркт міокарда [8,9]. Однак залишається дискутабельним питання зміни тенасцину С за умов наявності ЦД 2 типу у хворих на гострий інфаркт міокарда (ГІМ).…”

“…Результати, що отримали, не суперечать літературним даним. Згідно з науковими літературними джерелами [8,9], розвиток ГІМ асоціюється зі зростанням рівня тенасцину С.…”

“…Відношення шансів OR (odds ratio) для тенасцину С становило OR -5,6; ДІ 95% (1,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)8). Рівень значущості відмінності кривої від діагоналі p=0,25.…”