Combined copeptin and troponin to rule out myocardial infarction in patients with chest pain and a history of coronary artery disease
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Combined copeptin and troponin to rule out myocardial infarction in patients with chest pain and a history of coronary artery disease. / Ray, Patrick; Charpentier, Sandrine; Chenevier-Gobeaux, Camille; Reichlin, Tobias; Twerenbold, Raphael; Claessens, Yann Erick; Jourdain, Patrick; Riou, Bruno; Mueller, Christian.
in: AM J EMERG MED, Jahrgang 30, Nr. 3, 03.2012, S. 440-448.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Combined copeptin and troponin to rule out myocardial infarction in patients with chest pain and a history of coronary artery disease
AU - Ray, Patrick
AU - Charpentier, Sandrine
AU - Chenevier-Gobeaux, Camille
AU - Reichlin, Tobias
AU - Twerenbold, Raphael
AU - Claessens, Yann Erick
AU - Jourdain, Patrick
AU - Riou, Bruno
AU - Mueller, Christian
PY - 2012/3
Y1 - 2012/3
N2 - Purpose: The main objective of this multicentric study was to evaluate the additional value of copeptin to conventional cardiac troponin (cTn) for a rapid ruling out of acute myocardial infarction (AMI) in patients with acute chest pain and a previous history of coronary artery disease (CAD). Patients and Method: Patients with a previous history of CAD presenting in the emergency department with acute chest pain lasting for 6 hours or less suggestive of non-ST-segment elevation AMI and negative cTn were selected. Levels of copeptin were blindly measured at presentation. The diagnosis was adjudicated by 2 independent experts using all available data including cTn. Results: A total of 451 patients were included (mean age, 67 ± 14; 330 [73%] men). The adjudicated final diagnosis was AMI in 36 (8%) patients, unstable angina in 131 (29%), and other diagnosis in 284 (63%). A negative cTn combined with a copeptin value lower than 10.7 pmol/L at presentation was able to rule out AMI, with a negative predictive value of 98% (95% confidence interval, 95%-99%). Conclusion: In triage patients with acute chest pain lasting for less than 6 hours and a previous history of CAD, the combination of copeptin and cTn allows for the ruling out AMI, with a negative predictive value greater than 95%.
AB - Purpose: The main objective of this multicentric study was to evaluate the additional value of copeptin to conventional cardiac troponin (cTn) for a rapid ruling out of acute myocardial infarction (AMI) in patients with acute chest pain and a previous history of coronary artery disease (CAD). Patients and Method: Patients with a previous history of CAD presenting in the emergency department with acute chest pain lasting for 6 hours or less suggestive of non-ST-segment elevation AMI and negative cTn were selected. Levels of copeptin were blindly measured at presentation. The diagnosis was adjudicated by 2 independent experts using all available data including cTn. Results: A total of 451 patients were included (mean age, 67 ± 14; 330 [73%] men). The adjudicated final diagnosis was AMI in 36 (8%) patients, unstable angina in 131 (29%), and other diagnosis in 284 (63%). A negative cTn combined with a copeptin value lower than 10.7 pmol/L at presentation was able to rule out AMI, with a negative predictive value of 98% (95% confidence interval, 95%-99%). Conclusion: In triage patients with acute chest pain lasting for less than 6 hours and a previous history of CAD, the combination of copeptin and cTn allows for the ruling out AMI, with a negative predictive value greater than 95%.
UR - http://www.scopus.com/inward/record.url?scp=84858011180&partnerID=8YFLogxK
U2 - 10.1016/j.ajem.2011.12.008
DO - 10.1016/j.ajem.2011.12.008
M3 - SCORING: Journal article
C2 - 22402136
AN - SCOPUS:84858011180
VL - 30
SP - 440
EP - 448
JO - AM J EMERG MED
JF - AM J EMERG MED
SN - 0735-6757
IS - 3
ER -
