TY - JOUR
T1 - Plasma concentration of serotonin is a novel biomarker for coronarymicrovascular dysfunction in patients with suspected angina and unobstructive coronary arteries
AU - Odaka, Yuji
AU - Takahashi, Jun
AU - Tsuburaya, Ryuji
AU - Nishimiya, Kensuke
AU - Hao, Kiyotaka
AU - Matsumoto, Yasuharu
AU - Ito, Kenta
AU - Sakata, Yasuhiko
AU - Miyata, Satoshi
AU - Manita, Daisuke
AU - Hirowatari, Yuji
AU - Shimokawa, Hiroaki
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Aims Although the importance of coronary microvascular dysfunction (CMD) has been emerging, reliable biomarkers for CMD remain to be developed. We examined the potential usefulness of plasma concentration of serotonin to diagnose CMD in patients with suspected angina and unobstructive coronary arteries. Methods and results We enrolled 198 consecutive patients (M/F 116/82, 60.2613.3 years old) who underwent acetylcholine provocation test and measured plasma serotonin concentration. Coronary microvascular dysfunction was defined as myocardial lactate production without or prior to the occurrence of epicardial coronary spasm during acetylcholine provocation test. Although no statistical difference in plasma concentration of serotonin [median (inter-quartile range) nmol/L] was noted between the vasospastic angina (VSA) and non-VSA groups [6.8 (3.8, 10.9) vs. 5.1 (3.7, 8.4), P=0.135], it was significantly higher in patients with CMD compared with those without it [7.7 (4.5, 14.2) vs. 5.6 (3.7, 9.3), P=0.008]. Among the four groups classified according to the presence or absence of VSA and CMD, serotonin concentration was highest in the VSA with CMD group. Importantly, there was a positive correlation between plasma serotonin concentration and baseline thrombolysis in myocardial infarction frame count (P=0.001), a marker of coronary vascular resistance. The classification and regression trees analysis showed that plasma serotonin concentration of 9.55 nmol/L was the first discriminator to stratify the risk for the presence of CMD. In multivariable analysis, serotonin concentration greater than the cut-off value had the largest odds ratio in the prediction of CMD [odds ratio (95% confidence interval) 2.63 (1.28-5.49), P=0.009]. Conclusions Plasma concentration of serotonin may be a novel biomarker for CMD in patients with angina and unobstructive coronary arteries.
AB - Aims Although the importance of coronary microvascular dysfunction (CMD) has been emerging, reliable biomarkers for CMD remain to be developed. We examined the potential usefulness of plasma concentration of serotonin to diagnose CMD in patients with suspected angina and unobstructive coronary arteries. Methods and results We enrolled 198 consecutive patients (M/F 116/82, 60.2613.3 years old) who underwent acetylcholine provocation test and measured plasma serotonin concentration. Coronary microvascular dysfunction was defined as myocardial lactate production without or prior to the occurrence of epicardial coronary spasm during acetylcholine provocation test. Although no statistical difference in plasma concentration of serotonin [median (inter-quartile range) nmol/L] was noted between the vasospastic angina (VSA) and non-VSA groups [6.8 (3.8, 10.9) vs. 5.1 (3.7, 8.4), P=0.135], it was significantly higher in patients with CMD compared with those without it [7.7 (4.5, 14.2) vs. 5.6 (3.7, 9.3), P=0.008]. Among the four groups classified according to the presence or absence of VSA and CMD, serotonin concentration was highest in the VSA with CMD group. Importantly, there was a positive correlation between plasma serotonin concentration and baseline thrombolysis in myocardial infarction frame count (P=0.001), a marker of coronary vascular resistance. The classification and regression trees analysis showed that plasma serotonin concentration of 9.55 nmol/L was the first discriminator to stratify the risk for the presence of CMD. In multivariable analysis, serotonin concentration greater than the cut-off value had the largest odds ratio in the prediction of CMD [odds ratio (95% confidence interval) 2.63 (1.28-5.49), P=0.009]. Conclusions Plasma concentration of serotonin may be a novel biomarker for CMD in patients with angina and unobstructive coronary arteries.
KW - Coronary artery spasm
KW - Coronary microvascular dysfunction
KW - Serotonin
UR - http://www.scopus.com/inward/record.url?scp=85016171563&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85016171563&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehw448
DO - 10.1093/eurheartj/ehw448
M3 - Article
C2 - 27694191
AN - SCOPUS:85016171563
SN - 0195-668X
VL - 38
SP - 489
EP - 496
JO - European Heart Journal
JF - European Heart Journal
IS - 7
ER -