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
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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. / 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; Iversen, Kasper.
in: CLIN BIOCHEM, Jahrgang 59, 09.2018, S. 37-42.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - 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
AU - Árnadóttir, Ásthildur
AU - Schoos, Mikkel
AU - Lønborg, Jacob
AU - Ahtarovski, Kiril
AU - Kelbæk, Henning
AU - Helqvist, Steffen
AU - Høfsten, Dan
AU - Clemmensen, Peter
AU - Engstrøm, Thomas
AU - Nepper-Christensen, Lars
AU - Vejlstrup, Niels
AU - Køber, Lars
AU - Iversen, Kasper
N1 - Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
PY - 2018/9
Y1 - 2018/9
N2 - 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 (R2 = 0.02, p = .04), FIS (R2 = 0.03, p < .01) and MSI (R2 = 0.04, p < .01). Copeptin/troponin-ratio was significantly associated with symptom duration (R2 = 0.19, p < .01), but not AAR (R2 = 0.02, p = .19), FIS (R2 = 0.02, p = .12), or MSI (R2 = 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.
AB - 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 (R2 = 0.02, p = .04), FIS (R2 = 0.03, p < .01) and MSI (R2 = 0.04, p < .01). Copeptin/troponin-ratio was significantly associated with symptom duration (R2 = 0.19, p < .01), but not AAR (R2 = 0.02, p = .19), FIS (R2 = 0.02, p = .12), or MSI (R2 = 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.
KW - Adult
KW - Aged
KW - Biomarkers/blood
KW - Female
KW - Glycopeptides/analysis
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/diagnosis
KW - Myocardium/pathology
KW - Percutaneous Coronary Intervention/methods
KW - Predictive Value of Tests
KW - Prognosis
KW - Prospective Studies
KW - ST Elevation Myocardial Infarction/diagnosis
KW - Troponin T/analysis
U2 - 10.1016/j.clinbiochem.2018.06.012
DO - 10.1016/j.clinbiochem.2018.06.012
M3 - SCORING: Journal article
C2 - 29932892
VL - 59
SP - 37
EP - 42
JO - CLIN BIOCHEM
JF - CLIN BIOCHEM
SN - 0009-9120
ER -
