Chromogranin-A serum levels in patients with takotsubo syndrome and ST elevation acute myocardial infarction

Nicola Tarantino, Francesco Santoro, Luigi Di Biase, Vito Di Terlizzi, Enrica Vitale, Roberta Barone, Domenico Giovanni Della Rocca, Nicole Stephany De Leon De La Cruz, Matteo Di Biase, Natale Daniele Brunetti

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: Sympathergic hyperactivity is considered one of the main trigger precipitating takotsubo syndrome (TTS). Chromogranin-A (CgA), a prognostic biomarker of sympatho-adrenal activation, is markedly high in acute coronary syndrome (ACS) and heart failure (HF), but its role in TTS is unknown. Methods: CgA serum levels from patients with TTS and symptoms onset <24 hours were consecutively evaluated and compared with anterior ST-elevation myocardial infarction (STEMI) patients from November 2016 to December 2019. Short and long-term follow-up data were recorded. Results: Eleven women with TTS and 10 subjects with anterior STEMI were analyzed and compared; differences were not significant in terms of age, gender and cardiovascular risk factors. NT-pro-BNP levels were similar (9,887 ± 12,170 vs 8,969 ± 15,053 pg/ml, p = .88), while troponin-I levels were higher in patients with STEMI (4 ± 3.2 vs 13.3 ± 10 ng/dl, p = .03). CgA admission levels were significantly lower in TTS patients (2.2 ± 1.5 vs 7.3 ± 6.2 nMol/l, p = .017), even after multivariable correction for principal bias. CgA levels correlated with NTproBNP levels (p = .02) and were higher in subjects with in-hospital events (3.7 ± 1.1 vs 1.6 ± 1.2 nMol/l, p = .03), even after multivariable forward stepwise analysis (p < .01). CgA levels <3.25 nMol/l (AUC 0.754, 95% C.I. 0.54–0.968) were able to discriminate TTS from anterior STEMI (negative predictive power of 99%). Conclusions: Systemic CgA levels in the acute phase of TTS are lower than in anterior STEMI, possibly indicating a greater myocardial catecholamine release rather than adrenal.

Original languageEnglish (US)
Pages (from-to)12-17
Number of pages6
JournalInternational Journal of Cardiology
StatePublished - Dec 1 2020


  • Biomarkers
  • Cardiac sympathetic
  • Chromogranin-A
  • Prognosis
  • Takotsubo

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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