1. Can copeptin and troponin T ratio predict final infarct size and myocardial salvage index in patients with ST-elevation myocardial infarction: A sub-study of the DANAMI-3 trial.
- Author
-
Árnadóttir, Ásthildur, Schoos, Mikkel, Lønborg, Jacob, Ahtarovski, Kiril, Kelbæk, Henning, Helqvist, Steffen, Høfsten, Dan, Clemmensen, Peter, Engstrøm, Thomas, Nepper-Christensen, Lars, Vejlstrup, Niels, Køber, Lars, and Iversen, Kasper
- Subjects
- *
COPEPTINS , *TROPONIN , *SALVAGE therapy , *NECROSIS , *DIAGNOSIS ,MYOCARDIAL infarction diagnosis - Abstract
Background Primary percutaneous coronary intervention (pPCI) is recommended in patients presenting with ST-elevation myocardial infarction (STEMI) within <12 h of symptom onset. However, patients-reported symptom duration is not always reliable. Cardiac specific troponin T (cTnT) and the endogenous stress marker copeptin have different temporal release patterns for myocardial infarction MI. We hypothesized that copeptin/troponin-ratio is associated to the duration of coronary occlusion and therefore inversely proportional to myocardial salvage. Method Patients older than 18 years with first time STEMI referred to pPCI were eligible. cTnT and copeptin values were measured at admission. A cardiac magnetic resonance scanning (CMR) was done during the index admission for assessment of area at risk (AAR), and later 3 months to assess final infarct size (FIS). Myocardial salvage index (MSI) was calculated based on these measurements. Results A total of 468 patients were included. The median time from patient-reported onset of symptoms to pPCI was 192 min (IQR 150 min - 290 min). At presentation 416 (89%) patients had hs-cTnT values above the 99th percentile, median hs-cTnT was 53 ng/l (IQR 24 ng/l-146 ng/l) and 318 (68%) patients had copeptin values above the 99th percentile (18.9 pmol/l), median copeptin was 50 pmol/l (IQR 14 pmol/l-131 pmol/l). Symptom duration showed a weak but significant association with AAR (R 2 = 0.02, p = .04), FIS (R 2 = 0.03, p < .01) and MSI (R 2 = 0.04, p < .01). Copeptin/troponin-ratio was significantly associated with symptom duration (R 2 = 0.19, p < .01), but not AAR (R 2 = 0.02, p = .19), FIS (R 2 = 0.02, p = .12), or MSI (R 2 = 0.01, p = .25). Conclusion Copeptin/troponin-ratio is associated with patient-reported symptom duration, but there was no association with area at risk, final infarct size or myocardial salvage index. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF