The diagnostic value of tenascin-C in acute aortic syndrome

Area of Science:

• Cardiovascular Medicine
• Biomarker Discovery
• Emergency Medicine

Background:

• Acute aortic syndrome (AAS) diagnosis is critical due to high mortality.
• Tenascin-C (TN-C), an extracellular matrix glycoprotein, is linked to cardiovascular injury.
• The diagnostic utility of TN-C for AAS in Chinese patients with acute chest pain is not well-established.

Purpose of the Study:

• To investigate the plasma concentration of TN-C in patients presenting with chest or back pain.
• To evaluate TN-C's ability to discriminate between AAS and acute coronary syndrome (ACS).
• To assess TN-C as a potential early-stage biomarker for AAS.

Main Methods:

• Plasma TN-C levels were measured using ELISA in 376 patients with chest or back pain.
• Patients were categorized into AAS, ACS, and no cardiovascular disease (NCV) groups.
• Diagnostic performance metrics, including sensitivity, specificity, and ROC analysis, were calculated for TN-C.

Main Results:

• TN-C was significantly elevated in AAS (18.18 ng/mL) compared to ACS (7.51 ng/mL) and NCV (3.68 ng/mL) (P < 0.001).
• TN-C levels peaked in the acute stage of AAS.
• TN-C demonstrated high diagnostic accuracy (82.0%) with a sensitivity of 76.0% and specificity of 85.5% for AAS detection, outperforming D-dimer and hs-cTnT.

Conclusions:

• Serum TN-C concentrations are significantly higher in AAS patients compared to ACS and NCV groups.
• TN-C shows potential as a novel biomarker for early-stage differentiation of AAS from other pain-causing conditions.
• The study highlights TN-C's superior diagnostic performance in identifying AAS.