title: Mast cells and acute coronary syndromes: relationship between serum tryptase, clinical outcome and severity of coronary artery disease.
abstract: 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).
  
  
  
  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.
  
  
  
  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%).
  
  
  
  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.
authors.affiliation: Dipartimento Cardiotoracovascolare , SS UTIC/ SC Cardiologia 1-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
authors.forename: Nuccia
authors.initials: N
authors.lastname: Morici
authors.affiliation: Department of Laboratory Medicine , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Farioli
authors.affiliation: Department of Allergology and Immunology , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
authors.forename: Laura Michelina
authors.initials: LM
authors.lastname: Losappio
authors.affiliation: Medicine Department , Milano-Bicocca University , Milan , Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Colombo
authors.affiliation: Service of Biostatistics, Department of Hematology , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Nichelatti
authors.affiliation: Department of Allergology and Immunology , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Preziosi
authors.affiliation: Department of Allergology and Immunology , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Micarelli
authors.affiliation: Dipartimento Cardiotoracovascolare , SS UTIC/ SC Cardiologia 1-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Oliva
authors.affiliation: Medicine Department, Milano-Bicocca University, Milan, Italy; Cardiology IV, A. De Gasperis Department, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Giannattasio
authors.affiliation: Dipartimento Cardiotoracovascolare , SS UTIC/ SC Cardiologia 1-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Klugmann
authors.affiliation: Department of Allergology and Immunology , ASST Grande Ospedale Metropolitano Niguarda Ca' Granda , Milano , Italy.
authors.forename: Elide Anna
authors.initials: EA
authors.lastname: Pastorello
keywords: CORONARY ARTERY DISEASE