Prognostic value of serum tenascin-c levels on long-term outcome after acute myocardial infarction
Journal of Cardiac Failure, 05/29/2012
Sato A et al. – Serum Tenascin–C (TN–C) level on day 5 after admission is potentially useful for early risk stratification after acute myocardial infarction (AMI) beyond established prognostic markers.Methods
- Authors assessed 239 patients with first ST–segment elevation myocardial infarction who underwent successful percutaneous coronary intervention.
- They measured serum TN–C and plasma B–type natriuretic peptide (BNP) levels on day 5 after admission and compared long–term clinical outcome.
- During the follow–up period (24.3 ± 13 months), 54 patients experienced primary composite cardiac events (cardiac death or hospitalization for worsening heart failure).
- Multivariable Cox proportional hazards analysis indicated that serum TN–C (hazard ratio 2.92, 95% confidence interval [CI] 1.55–5.67; P < .001) and plasma BNP levels (hazard ratio 1.84, 95% CI 1.17–2.97; P = .008) were significant independent predictors for cardiac events after adjustment for multiple confounders.
- The combination of TN–C and BNP resulted in an increase of the c–statistic from 0.821 to 0.877 (P < .001) and an integrated discrimination improvement gain of 14.0% (P < .001).