PT  - JOURNAL ARTICLE
AU  - Nuccia Morici
AU  - Laura Farioli
AU  - Laura Michelina Losappio
AU  - Giulia Colombo
AU  - Michele Nichelatti
AU  - Donatella Preziosi
AU  - Gianluigi Micarelli
AU  - Fabrizio Oliva
AU  - Cristina Giannattasio
AU  - Silvio Klugmann
AU  - Elide Anna Pastorello
TI  - Mast cells and acute coronary syndromes: relationship between serum tryptase, clinical outcome and severity of coronary artery disease
AID  - 10.1136/openhrt-2016-000472
DP  - 2016 Sep 01
TA  - Open Heart
PG  - e000472
VI  - 3
IP  - 2
4099  - http://openheart.bmj.com/content/3/2/e000472.short
4100  - http://openheart.bmj.com/content/3/2/e000472.full
SO  - Open Heart2016 Sep 01; 3
AB  - 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.