Serum tryptase levels in acute coronary syndromes

Kervinen, Helena; Kaartinen, Maija; Mäkynen, Heikki; Palosuo, Timo; Mänttäri, Matti; Kovanen, Petri T.

doi:10.1016/j.ijcard.2004.10.023

Cited by 29 publications

(26 citation statements)

References 34 publications

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“…An increase in mast cell numbers or pronounced activation of mast cells may be reflected by higher ST levels. One study investigating ST after acute coronary syndromes did not find elevated ST levels [14], but concluded that the numbers of mast cells activated in the coronary arteries probably were too few to detect a systemic increase in ST. However, the studies on this subject have included a limited number of patients [12,13,14].…”

Section: Introductionmentioning

confidence: 99%

“…One study investigating ST after acute coronary syndromes did not find elevated ST levels [14], but concluded that the numbers of mast cells activated in the coronary arteries probably were too few to detect a systemic increase in ST. However, the studies on this subject have included a limited number of patients [12,13,14]. A Spanish general population study [15] in 420 adults found that increasing ST levels were associated with increasing BMI and the metabolic syndrome, but these associations were not statistically significant after adjustment for potential confounders.…”

Section: Introductionmentioning

confidence: 99%

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Determinants of Serum Tryptase in a General Population: The Relationship of Serum Tryptase to Obesity and Asthma

Fenger

Linneberg

Vidal

et al. 2011

Int Arch Allergy Immunol

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Background: Recent studies indicate that mast cells are more abundant in the obese state. Total serum tryptase (ST) is a marker of mast cell numbers or activity. Since obesity and asthma have been consistently linked in epidemiological studies, a possible higher mast cell activity in obesity could be a factor between the two conditions. The aim of this study was to investigate determinants of ST and whether a potential association between obesity and allergic respiratory disease would be influenced by levels of ST in obese persons. Methods: Measurements of ST (ImmunoCAP Tryptase assay), atopy (skin prick test reactivity), methacholine bronchial hyperresponsiveness (BHR), body mass index (BMI) and serum lipids were performed in a general population of 1,216 persons aged 15–69 years. Results: ST increased significantly with increasing BMI. The median ST level increased from 3.3 µg/l in persons with BMI <25 to 4.4 µg/l in persons with BMI >30, p < 0.0001. Age (p < 0.0001), male sex (p = 0.0009) and smoking (p = 0.022) were positively associated with ST, whereas alcohol consumption (p = 0.005) was inversely associated with ST. ST was not associated with atopy, symptoms of allergic respiratory disease or BHR. A positive association between symptoms of allergic respiratory disease and obesity (OR = 1.98, 95% CI = 1.25–3.14) was not influenced by obesity-related differences in ST. Conclusions: Increasing BMI was significantly associated with increasing ST and the prevalence of symptoms of allergic respiratory disease. However, mast cell activity/burden (assessed by ST levels) did not influence the association between BMI and asthma/rhinitis symptoms.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Determinants of Serum Tryptase in a General Population: The Relationship of Serum Tryptase to Obesity and Asthma

Fenger

Linneberg

Vidal

et al. 2011

Int Arch Allergy Immunol

View full text Add to dashboard Cite

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“…This explains the lack of conclusive remarks in previous studies. In the Chinese study [12] (on the clinical meaning of tryptase increase in AMI patients), the authors found that not all AMI patients presented increased tryptase levels, and the researchers did not mention anything about complications (similarly to the Finnish study [11] in which some patients had increased tryptase levels but the mean values in the AMI population did not differ from those of the controls). In this study, we found that only complex AMI patients were characterized by an increase in tryptase and that this result was valid for all but 3 of the patients.…”

Section: Discussionmentioning

confidence: 99%

“…Two larger studies have recently been published on this issue. Kervinen et al [11 ]analyzed serum tryptase in 183 patients admitted to a hospital with chest pain [including 60 patients with unstable angina and 59 with acute myocardial infarction (AMI)]. Among these patients, tryptase levels did not differ from controls and remained stable without any relevant difference at different points in time.…”

Section: Introductionmentioning

confidence: 99%

Serum Tryptase: A New Biomarker in Patients with Acute Coronary Syndrome?

Pastorello

Morici²,

Farioli³

et al. 2014

Int Arch Allergy Immunol

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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.

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“…It is useful to demonstrate that an allergic reaction has happened [1]. In addition, tryptase levels are currently being investigated in acute coronary syndromes (ACS) because the mast cells invade the coronary plaques before rupture or erosion has occurred [2,3].…”

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confidence: 99%