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Original research article
Mast cells and acute coronary syndromes: relationship between serum tryptase, clinical outcome and severity of coronary artery disease
  1. Nuccia Morici1,
  2. Laura Farioli2,
  3. Laura Michelina Losappio3,
  4. Giulia Colombo4,
  5. Michele Nichelatti5,
  6. Donatella Preziosi3,
  7. Gianluigi Micarelli3,
  8. Fabrizio Oliva1,
  9. Cristina Giannattasio4,6,
  10. Silvio Klugmann1 and
  11. Elide Anna Pastorello3
  1. 1Dipartimento Cardiotoracovascolare, SS UTIC/ SC Cardiologia 1-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda Ca’ Granda, Milano, Italy
  2. 2Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda Ca’ Granda, Milano, Italy
  3. 3Department of Allergology and Immunology, ASST Grande Ospedale Metropolitano Niguarda Ca’ Granda, Milano, Italy
  4. 4Medicine Department, Milano-Bicocca University, Milan, Italy
  5. 5Service of Biostatistics, Department of Hematology, ASST Grande Ospedale Metropolitano Niguarda Ca’ Granda, Milano, Italy
  6. 6Cardiology IV, A. De Gasperis Department, ASST Grande Ospedale Metropolitano Niguarda Ca’ Granda, Milan, Italy
  1. Correspondence to Dr Nuccia Morici; nuccia.morici{at}


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.


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