Evidence map›Paper›PMID 41794829›Full record

Observational studyScientific reports2026

Allergy-associated acute coronary syndrome without anaphylaxis in a prospective observational study.

Mari Amino, Shie Takizawa, Seiji Morita, Kanae Kitatani, Ayumi Sasaki, Atsuhiko Yagishita, Yoshihide Nakagawa, Yuji Ikari, Koichiro Yoshioka

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mari AminoDepartment of Cardiovascular Medicine, Tokai University, Shimokasuya 143, Isehara, Kanagawa, 259-1193, Japan. mariamino@tokai.ac.jp.
Shie TakizawaDepartment of Emergency and Critical Care Medicine, Tokai University, Shimokasuya 143, Isehara, Kanagawa, 259-1193, Japan.
Seiji MoritaDepartment of Emergency and Critical Care Medicine, Tokai University, Shimokasuya 143, Isehara, Kanagawa, 259-1193, Japan.
Kanae KitataniDepartment of Life Science Support, Research Innovation Center, University Hospitals Sector, Tokai University, Shimokasuya 143, Isehara, Kanagawa, 259-1193, Japan.
Ayumi SasakiDepartment of Life Science Support, Research Innovation Center, University Hospitals Sector, Tokai University, Shimokasuya 143, Isehara, Kanagawa, 259-1193, Japan.
Atsuhiko YagishitaDepartment of Cardiovascular Medicine, Tokai University, Shimokasuya 143, Isehara, Kanagawa, 259-1193, Japan.
Yoshihide NakagawaDepartment of Emergency and Critical Care Medicine, Tokai University, Shimokasuya 143, Isehara, Kanagawa, 259-1193, Japan.
Yuji IkariDepartment of Cardiovascular Medicine, Tokai University, Shimokasuya 143, Isehara, Kanagawa, 259-1193, Japan.
Koichiro YoshiokaDepartment of Cardiovascular Medicine, Tokai University, Shimokasuya 143, Isehara, Kanagawa, 259-1193, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Kounis syndrome is an acute coronary syndrome (ACS) triggered by allergic reactions via mast cell activation, classically accompanied by anaphylaxis. However, ACS associated with mild or subclinical allergic reactions may be underrecognized. We investigated immune markers and autonomic nervous system activity in patients with ACS and characterized allergy-associated ACS without anaphylactic symptoms. Among 375 patients treated for ACS (April 2022 to March 2024), 49 were prospectively enrolled. Patients were classified into non-allergy-associated ACS (ACS-NA, n = 32) and allergy-associated ACS (ACS-AL, n = 17) groups. ACS-AL was subdivided into the non-anaphylactic (ACS-AL(nonA), n = 11) and anaphylactic (ACS-AL(withA), n = 6) groups. Allergic status was comprehensively assessed. Serum IgE and plasma histamine were measured at ACS onset. Heart rate variability (HRV) parameters were analyzed using 24-h ambulatory monitoring within 1 week after percutaneous coronary intervention. The ACS-AL(nonA) and ACS-AL(withA) groups showed significantly higher IgE and histamine levels than the ACS-NA group (P < 0.05), with overlapping distributions. HRV analysis revealed elevated LF/HF ratios and reduced daytime HF in both groups, indicating sympathetic predominance. ACS-AL, even without anaphylaxis, involves immune activation and autonomic imbalance. Combined assessment of IgE, histamine, and HRV may improve the identification of this phenotype.

Indexed as

Acute Coronary SyndromeAnaphylaxisHypersensitivityKounis SyndromeAgedBiomarkersFemaleHeart RateHistamineHumansImmunoglobulin EMaleMiddle AgedProspective StudiesBiomarkersHistamineImmunoglobulin EAcute coronary syndromeAllergyAutonomic nervous systemHistamineIgEKounis syndrome

Identifiers

PMID41794829
PMCPMC13087291

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.