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2016;3 (2): e000472.

Mast cells and acute coronary syndromes: relationship between serum tryptase, clinical outcome and severity of coronary artery disease.

Nuccia Morici, Laura Farioli, Laura Michelina Losappio, Giulia Colombo, Michele Nichelatti, Donatella Preziosi, Gianluigi Micarelli, Fabrizio Oliva, Cristina Giannattasio, Silvio Klugmann, Elide Anna Pastorello
Author Information
  1. Nuccia Morici: Dipartimento Cardiotoracovascolare , SS UTIC/ SC Cardiologia 1-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
  2. Laura Farioli: Department of Laboratory Medicine , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
  3. Laura Michelina Losappio: Department of Allergology and Immunology , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
  4. Giulia Colombo: Medicine Department , Milano-Bicocca University , Milan , Italy.
  5. Michele Nichelatti: Service of Biostatistics, Department of Hematology , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
  6. Donatella Preziosi: Department of Allergology and Immunology , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
  7. Gianluigi Micarelli: Department of Allergology and Immunology , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
  8. Fabrizio Oliva: Dipartimento Cardiotoracovascolare , SS UTIC/ SC Cardiologia 1-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
  9. Cristina Giannattasio: Medicine Department, Milano-Bicocca University, Milan, Italy; Cardiology IV, A. De Gasperis Department, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda, Milan, Italy.
  10. Silvio Klugmann: Dipartimento Cardiotoracovascolare , SS UTIC/ SC Cardiologia 1-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
  11. Elide Anna Pastorello: Department of Allergology and Immunology , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
PMID: 27752333 DOI: 10.1136/openhrt-2016-000472

Abstract

OBJECTIVE: To assess the relationship between serum tryptase and the occurrence of major cardiovascular and cerebrovascular events (MACCE) at 2-year follow-up in patients admitted with acute coronary syndrome (ACS). To compare serum tryptase to other validated prognostic markers (maximum high-sensitivity troponin (hs-Tn), C reactive protein (CRP) levels at admission, Synergy between percutaneous coronary intervention with Taxus and Cardiac Surgery (SYNTAX) score).
METHODS: We measured serum tryptase at admission in 140 consecutive patients with ACS and in 50 healthy controls. The patients' follow-up was maintained for 2 years after discharge. The predictive accuracy of serum tryptase for 2-year MACCE was assessed and compared with hs-Tn, CRP and SYNTAX score.
RESULTS: Serum tryptase levels at admission were significantly higher in patients with ACS compared with the control group (p=0.0351). 2 years after discharge, 28/140 patients (20%) experienced MACCE. Serum tryptase levels, maximum hs-Tn measurements and SYNTAX score were higher in patients who experienced MACCE compared with those without (p<0.0001). Conversely, we found no significant association between MACCE and CRP. The predictive accuracy of serum tryptase for MACCE was set at the cut-off point of 6.7 ng/mL (sensitivity 46%, specificity 84%).
CONCLUSIONS: In patients with ACS, serum tryptase measured during index admission is significantly correlated to the development of MACCE up to 2 years, demonstrating a possible long-term prognostic role of this biomarker.

Keywords

CORONARY ARTERY DISEASE

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Journal Article
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Word Cloud

Created with Highcharts 10.0.0tryptaseserumMACCEpatientscoronaryACSadmissionhs-TnCRPlevelsSYNTAXscorecomparedrelationship2-yearfollow-upacuteprognosticmaximummeasured2 yearsdischargepredictiveaccuracySerumsignificantlyhigherexperiencedOBJECTIVE:assessoccurrencemajorcardiovascularcerebrovasculareventsadmittedsyndromecomparevalidatedmarkershigh-sensitivitytroponinCreactiveproteinSynergypercutaneousinterventionTaxusCardiacSurgeryMETHODS:140consecutive50healthycontrolspatients'maintainedassessedRESULTS:controlgroupp=003512years28/14020%measurementswithoutp<00001Converselyfoundsignificantassociationsetcut-offpoint67 ng/mLsensitivity46%specificity84%CONCLUSIONS:indexcorrelateddevelopmentdemonstratingpossiblelong-termrolebiomarkerMastcellssyndromes:clinicaloutcomeseverityarterydiseaseCORONARYARTERYDISEASE

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