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Current Cardiology Reviews

Editor-in-Chief

ISSN (Print): 1573-403X
ISSN (Online): 1875-6557

Case Report

Acute Myocardial Infarction in Systemic Mastocytosis: Case Report With Literature Review on the Role of Inflammatory Process in Acute Coronary Syndrome

Author(s): Ayman Battisha*, Khalid Sawalha, Bader Madoukh, Omar Sheikh, Karim Doughem, Mohammad Al-Akchar, Mohammed Al-Sadawi and Shakil Shaikh

Volume 16 , Issue 4 , 2020

Page: [333 - 337] Pages: 5

DOI: 10.2174/1573403X16666200331123242

Price: $65

Abstract

Background: Systemic Mastocytosis (SM) is a disorder of excessive mast cell infiltration in multiple organ tissues. Atherosclerosis is a major risk factor for developing acute coronary syndrome. In addition to lipid accumulation in the arterial wall, inflammation plays an important role in the pathogenesis of plaque rupture and activating the thrombosis cascade. The Mast cells contribution to plaque destabilization has been well established in multiple animal and human studies. In a recent study, SM has been proven to be associated with a higher incidence of acute coronary syndrome even with lower plasma lipids levels. The study showed that 20% of patients with SM had cardiovascular events compared to only 6% in the control group with adjustment to all cardiac risk factors.

Case: We presented a patient with no risk factors for heart disease other than old age and history of SM who developed acute myocardial infarction.

Conclusion: SM can be life-threatening and can result in ACS, anaphylactic reaction, syncope, or cardiac arrest. Clinicians should have a high index of suspicion of acute coronary syndrome (ACS) occurrence in the setting of inflammatory conditions, such as SM and KS, and vice versa, where SM should be considered or ruled out in patients who suffer from anaphylaxis and cardiac arrest or myocardial infarction.

Keywords: SM, electrocardiogram, subclinical hypothyroidism, patient, myocardial infarction, acute coronary syndrome.

Graphical Abstract
[1]
Shah PK. Mechanisms of plaque vulnerability and rupture. J Am Coll Cardiol 2003; 41(4)(Suppl. S): 15S-22S.
[http://dx.doi.org/10.1016/S0735-1097(02)02834-6 PMID: 12644336]
[2]
Stoll G, Bendszus M. Inflammation and atherosclerosis: Novel insights into plaque formation and destabilization. Stroke 2006; 37(7): 1923-32.
[http://dx.doi.org/10.1161/01.STR.0000226901.34927.10 PMID: 16741184]
[3]
Lagraauw HM, Wezel A, van der Velden D, Kuiper J, Bot I. Stress-induced mast cell activation contributes to atherosclerotic plaque destabilization. Sci Rep 2019; 9(1): 2134.
[http://dx.doi.org/10.1038/s41598-019-38679-4 PMID: 30765859]
[4]
Indhirajanti S, van Daele PLA, Bos S, Mulder MT, Bot I, Roeters van Lennep JE. Systemic mastocytosis associates with cardiovascular events despite lower plasma lipid levels. Atherosclerosis 2018; 268: 152-6.
[http://dx.doi.org/10.1016/j.atherosclerosis.2017.11.030 PMID: 29227868]
[5]
Paratz ED, Khav N, Burns AT. Systemic mastocytosis, Kounis syndrome and coronary intervention: Case report and systematic review. Heart Lung Circ 2017; 26(8): 772-8.
[http://dx.doi.org/10.1016/j.hlc.2016.12.009 PMID: 28242292]
[6]
Hermans M, Lennep JRV, van Daele P, Bot I. Mast cells in cardiovascular disease: From bench to bedside. Int J Mol Sci 2019; 20(14): 3395.
[http://dx.doi.org/10.3390/ijms20143395 PMID: 31295950]
[7]
Broesby-Olsen S, Farkas DK, Vestergaard H, et al. Risk of solid cancer, cardiovascular disease, anaphylaxis, osteoporosis and fractures in patients with systemic mastocytosis: A nationwide population-based study. Am J Hematol 2016; 91(11): 1069-75.
[http://dx.doi.org/10.1002/ajh.24490 PMID: 27428296]
[8]
Bot I, Shi GP, Kovanen PT. Mast cells as effectors in atherosclerosis. Arterioscler Thromb Vasc Biol 2015; 35(2): 265-71.
[http://dx.doi.org/10.1161/ATVBAHA.114.303570 PMID: 25104798]
[9]
Niccoli G, Montone RA, Sabato V, Crea F. Role of allergic inflammatory cells in coronary artery disease. Circulation 2018; 138(16): 1736-48.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.118.035400 PMID: 30354461]
[10]
Huang A L, Bosco J J, Peter K. Mast cell: An unexpected villain in venous thromboembolism? 2017; 121(8): 899-901.
[http://dx.doi.org/10.1161/CIRCRESAHA.117.311777] [PMID: 28963183]
[11]
Erdogan O, Altun A, Gazi S, Ozbay G. Loratidine improves ischemic parameters of exercise stress test in patients with acute myocardial infarction. Am Heart J 2004; 148(6)e24
[http://dx.doi.org/10.1016/j.ahj.2004.04.048 PMID: 15632861]
[12]
Ridolo E, Triggiani M, Montagni M, et al. Mastocytosis presenting as cardiac emergency. Intern Emerg Med 2013; 8(8): 749-52.
[http://dx.doi.org/10.1007/s11739-013-1012-0 PMID: 24136074]
[13]
Rohr SM, Rich MW, Silver KH. Shortness of breath, syncope, and cardiac arrest caused by systemic mastocytosis. Ann Emerg Med 2005; 45(6): 592-4.
[http://dx.doi.org/10.1016/j.annemergmed.2005.02.002 PMID: 15940090]
[14]
Thomas D, Dragodanne C, Frank R, Prier A, Chomette G, Grosgogeat Y. Systemic mastocytosis with myo-pericardial localization and atrioventricular block. Arch Mal Coeur Vaiss 1981; 74(2): 215-21.
[PMID: 6782979]
[15]
Kounis NG. Coronary hypersensitivity disorder: The Kounis syndrome. Clin Ther 2013; 35(5): 563-71.
[http://dx.doi.org/10.1016/j.clinthera.2013.02.022 PMID: 23490289]
[16]
Rigger J, Ehl NF, Nägele R, Rickli H, Maeder MT. Kounis syndrome revisited: Systemic mastocytosis and severe coronary artery disease. Int J Cardiol 2016; 214: 510-1.
[http://dx.doi.org/10.1016/j.ijcard.2016.03.154 PMID: 27040990]
[17]
Kaartinen M, Penttilä A, Kovanen PT. Accumulation of activated mast cells in the shoulder region of human coronary atheroma, the predilection site of atheromatous rupture. Circulation 1994; 90(4): 1669-78.
[http://dx.doi.org/10.1161/01.CIR.90.4.1669 PMID: 7923651]
[18]
Ridker PM, Everett BM, Thuren T, et al. CANTOS Trial Group. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med 2017; 377(12): 1119-31.
[http://dx.doi.org/10.1056/NEJMoa1707914 PMID: 28845751]
[19]
James SK, Lindahl B, Siegbahn A, et al. N-terminal pro-brain natriuretic peptide and other risk markers for the separate prediction of mortality and subsequent myocardial infarction in patients with unstable coronary artery disease: A Global Utilization of Strategies To Open occluded arteries (GUSTO)-IV substudy. Circulation 2003; 108(3): 275-81.
[http://dx.doi.org/10.1161/01.CIR.0000079170.10579.DC PMID: 12847065]
[20]
Chan AW, Bhatt DL, Chew DP, et al. Relation of inflammation and benefit of statins after percutaneous coronary interventions. Circulation 2003; 107(13): 1750-6.
[http://dx.doi.org/10.1161/01.CIR.0000060541.18923.E9 PMID: 12665489]
[21]
Berwanger O, Santucci EV, de Barros E, Silva PGM, et al. SECURE-PCI Investigators Effect of loading dose of atorvastatin prior to planned percutaneous coronary intervention on major adverse cardiovascular events in acute coronary syndrome: the SECURE-PCI randomized clinical trial. JAMA 2018; 319(13): 1331-40.
[http://dx.doi.org/10.1001/jama.2018.2444 PMID: 29525821]
[22]
Husebye T, Eritsland J, Arnesen H, et al. Association of interleukin 8 and myocardial recovery in patients with ST-elevation myocardial infarction complicated by acute heart failure. PLoS One 2014; 9(11)e112359
[http://dx.doi.org/10.1371/journal.pone.0112359 PMID: 25390695]
[23]
Limalanathan S, Andersen GØ, Hoffmann P, Kløw NE, Abdelnoor M, Eritsland J. Rationale and design of the POSTEMI (postconditioning in ST-elevation myocardial infarction) study. Cardiology 2010; 116(2): 103-9.
[http://dx.doi.org/10.1159/000316965 PMID: 20588018]
[24]
Rymer JA, Newby LK. Failure to launch: Targeting inflammation in acute coronary syndromes. JACC Basic Transl Sci 2017; 2(4): 484-97.
[http://dx.doi.org/10.1016/j.jacbts.2017.07.001 PMID: 30062164]
[25]
Tardif JC, Kouz S, Waters DD, et al. Efficacy and safety of low-dose colchicine after myocardial infarction. N Engl J Med 2019; 381(26): 2497-505.
[http://dx.doi.org/10.1056/NEJMoa1912388 PMID: 31733140]
[26]
Ridker PM, Everett BM, Pradhan A, et al. CIRT Investigators Low-dose methotrexate for the prevention of atherosclerotic events. N Engl J Med 2019; 380(8): 752-62.
[http://dx.doi.org/10.1056/NEJMoa1809798 PMID: 30415610]
[27]
Fiedler LR. Antibody based therapy in coronary artery disease and heart failure. Heart Res Open J 2017; 4(2): 39-45.
[http://dx.doi.org/10.17140/HROJ-4-140]

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