Back to Search Start Over

Copeptin Improves Early Diagnosis of Acute Myocardial Infarction

Authors :
Stergios Tzikas
C. Sinning
Francisco Ojeda
Till Keller
Oliver Hartmann
Sabine Genth-Zotz
Christoph Bickel
Andreas Bergmann
Lars Lillpopp
Alexander Roth
Dirk Peetz
Viviane Nicaud
Laurence Tiret
Stefan Blankenberg
Felix Post
Edith Lubos
Ewa Czyz
Jan Kunde
Thomas Münzel
Stephan Baldus
Tanja Zeller
Karl J. Lackner
Philipp S. Wild
Source :
Journal of the American College of Cardiology. 55(19):2096-2106
Publication Year :
2010
Publisher :
Elsevier BV, 2010.

Abstract

ObjectivesEarly identification of myocardial infarction in chest pain patients is crucial to identify patients at risk and to maintain a fast treatment initiation.BackgroundThe aim of the current investigation is to test whether determination of copeptin, an indirect marker for arginin-vasopressin, adds diagnostic information to cardiac troponin in early evaluation of patients with suspected myocardial infarction.MethodsBetween January 2007 and July 2008, patients with suspected acute coronary syndrome were consecutively enrolled in this multicenter study. Copeptin, troponin T (TnT), myoglobin, and creatine kinase-myocardial band were determined at admission and after 3 and 6 h.ResultsOf 1,386 (66.4% male) enrolled patients, 299 (21.6%) had the discharge diagnosis of acute myocardial infarction, 184 (13.3%) presented with unstable angina, and in 903 (65.2%) an acute coronary syndrome could be excluded. Combined measurement of copeptin and TnT on admission improved the c-statistic from 0.84 for TnT alone to 0.93 in the overall population and from 0.77 to 0.9 in patients presenting within 3 h after chest pain onset (CPO) (p < 0.001). In this group the combination of copeptin with a conventional TnT provided a negative predictive value of 92.4%.ConclusionsIn triage of chest pain patients, determination of copeptin in addition to troponin improves diagnostic performance, especially early after CPO. Combined determination of troponin and copeptin provides a remarkable negative predictive value virtually independent of CPO time and therefore aids in early and safe rule-out of myocardial infarction.

Details

ISSN :
07351097
Volume :
55
Issue :
19
Database :
OpenAIRE
Journal :
Journal of the American College of Cardiology
Accession number :
edsair.doi.dedup.....b7f0c3eda961a8eec3b960aa931851e4
Full Text :
https://doi.org/10.1016/j.jacc.2010.01.029