title: 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%).
  
  
  CONCLUSIONS
  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.affiliation: Department of Allergology and Immunology, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Elide Anna
authors.initials: EA
authors.lastname: Pastorello
authors.forename: Nuccia
authors.initials: N
authors.lastname: Morici
authors.forename: Laura
authors.initials: L
authors.lastname: Farioli
authors.forename: Matteo
authors.initials: M
authors.lastname: Di Biase
authors.forename: Laura Michelina
authors.initials: LM
authors.lastname: Losappio
authors.forename: Michele
authors.initials: M
authors.lastname: Nichelatti
authors.forename: Loredana
authors.initials: L
authors.lastname: Lupica
authors.forename: Jan Walter
authors.initials: JW
authors.lastname: Schroeder
authors.forename: Chrysi
authors.initials: C
authors.lastname: Stafylaraki
authors.forename: Silvio
authors.initials: S
authors.lastname: Klugmann
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D053802:Tryptases / Q000097:blood*
chemical_list: D015415:Biomarkers; D053802:Tryptases