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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.
- Source :
-
Clinical biochemistry [Clin Biochem] 2018 Sep; Vol. 59, pp. 37-42. Date of Electronic Publication: 2018 Jun 20. - Publication Year :
- 2018
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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.<br />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.<br />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 <superscript>2</superscript> = 0.02, p = .04), FIS (R <superscript>2</superscript> = 0.03, p < .01) and MSI (R <superscript>2</superscript> = 0.04, p < .01). Copeptin/troponin-ratio was significantly associated with symptom duration (R <superscript>2</superscript> = 0.19, p < .01), but not AAR (R <superscript>2</superscript> = 0.02, p = .19), FIS (R <superscript>2</superscript> = 0.02, p = .12), or MSI (R <superscript>2</superscript> = 0.01, p = .25).<br />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.<br /> (Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Biomarkers blood
Female
Glycopeptides blood
Humans
Male
Middle Aged
Myocardial Infarction diagnosis
Myocardium pathology
Percutaneous Coronary Intervention methods
Predictive Value of Tests
Prognosis
Prospective Studies
Troponin T blood
Glycopeptides analysis
ST Elevation Myocardial Infarction diagnosis
Troponin T analysis
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2933
- Volume :
- 59
- Database :
- MEDLINE
- Journal :
- Clinical biochemistry
- Publication Type :
- Academic Journal
- Accession number :
- 29932892
- Full Text :
- https://doi.org/10.1016/j.clinbiochem.2018.06.012