Association Of Serum Tryptase Level And Cigarette Smoking In Acute Myocardial Infarction Patients

Coronary artery atherosclerotic plaque rupture and secondary thrombogenesis is the main mechanism of acute myocardial infarction. Multiple types of inflammatory cells participate in this process. Recent researches showed that mast cells in vessel walls can be activated by several artery atherosclerosis risk factors, and release pro-inflammation factors through degranulation, which mediates local inflammatory effects in coronary arteries. Activation of mast cells is one of the main risk factors for coronary atherosclerotic plaque rupture. In patients with acute myocardial infarction, mast cell aggregation and activation can be observed near the rupture border of atherosclerotic plaques. Smoking is a considered as a risk factor for coronary artery disease. So far the association of smoking and blood vessel mast cell activation is not clear. Tryptase is a mast cell specific neutral serine protease. Researches have shown that the serum concentration of tryptase can reveal the activation of mast cells.ObjectiveWe sought to declare the association between mast cell activation and smoking through research on the correlation of serum tryptase level, smoking and other risk factors in acute myocardial infarction patients.Materials and MethodsWe studied375patients who were admitted in Cardiology department in2nd Affiliated Hospital of Zhejiang University during January1st-October1st2014with an chief complaint of chest distress, chest pain, or chest discomfort; LVEF<50%, abnormal elevation in cardiac enzymes or changes in ST-T segment in ECG. Patients underwent coronary angiography and were divided into two groups according to diagnosis:patients diagnosed as acute myocardial infarction (n=183) and non-coronary artery disease (n=192). Blood samples are stored at-80℃and analyzed with TPS kit from Cloud Clone Corp. Results were analyzed with SPSS16.0, P<0.05is considered significant.ResultsSerum tryptase level in patients with acute myocardial infarction is significantly higher than that in non-coronary artery disease (6.32±0.26vs.0.33±0.04, p<0.05), yet there is no difference in patients with Non ST-elevated myocardial infarction and ST-elevated myocardial infaction. High serum tryptase level is an independent risk factor for acute myocardil infarction. Patients with acute myocardial infarction smokes more than those without coronary artery disease. Serum tryptase level is significantly different between patients with acute myocardial infarction and non-coronary artery disease (2.56±0.24vs.3.95±0.34, p<0.05). Serum tryptase level is independently relative to the amount of cigarette smoking (P=0.183, p=0.000).ConclusionsIn patients with acute myocardial infarction, serum tryptase level is not significantly different between smokers and no-smokers, while in all patients researched, the difference is significant. This could be because of the difference in WBC levels between the two groups. In our next resesarch we will include more patients to minimize the bias caused by baseline difference.