Serum tryptase: a new biomarker in patients with acute coronary syndrome?

Abstract

BACKGROUND:

Mast cell tryptase has recently been reported to be involved in atherosclerotic plaque destabilization. However, the results of these reports are conflicting.

METHODS:

The aim of this study was to characterize the role of tryptase as a prognostic marker of patient cardiovascular complexity in acute coronary syndrome (ACS). Furthermore, its association with an angiographic scoring system [defined by the SYNergy between percutaneous coronary intervention (PCI) with the TAXUS drug-eluting stent and the cardiac surgery (SYNTAX) score] was examined. The serum tryptase was measured at admission in 65 consecutive ACS patients and in 35 healthy controls. In the patients with ACS, a composite measure of clinical and angiographic patient cardiovascular complexity was indicated by two of the following: clinical adverse events at hospitalization, at least 2 epicardial coronary arteries involved in the atherosclerotic disease, more than 1 stent implanted or more than 2 coronary artery disease risk factors.

RESULTS:

The tryptase measurements were lower in patients without the composite measure (p < 0.0005). Linear regression showed a significant relationship between tryptase levels and the SYNTAX score (SX-score). Conversely, high-sensitivity troponin values did not correlate with either the composite outcome or the SX-score. The predictive accuracy of serum tryptase for the composite outcome was set at the cut-off point of 5.22 ng/ml (sensitivity 81% and specificity 95.7%).

CONCLUSION:

In ACS patients, serum tryptase levels at admission may predict patient cardiovascular complexity more reliably than currently known biomarkers. Further studies are needed to demonstrate the long-term prognostic role of this biomarker in ACS.

• Authors: Elide Anna Pastorello, Nuccia Morici, Laura Farioli, Matteo Di Biase, Laura Michelina Losappio, Michele Nichelatti, Loredana Lupica, Jan Walter Schroeder, Chrysi Stafylaraki, Silvio Klugmann
• Journal: International archives of allergy and immunology (Int Arch Allergy Immunol) Vol. 164 Issue 2 Pg. 97-105 ( 2014) ISSN: 1423-0097 [Electronic] Switzerland
• PMID: 24943670 (Publication Type: Journal Article)
• Copyright: © 2014 S. Karger AG, Basel.

Chemical References

• Biomarkers
• Tryptases

Topics

• Acute Coronary Syndrome (blood, pathology)
• Aged
• Aged, 80 and over
• Biomarkers (blood)
• Female
• Humans
• Male
• Middle Aged
• Prognosis
• Risk Factors
• Tryptases (blood)