Copeptin improves early diagnosis of acute myocardial infarction
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Copeptin improves early diagnosis of acute myocardial infarction. / Keller, Till; Tzikas, Stergios; Zeller, Tanja; Czyz, Ewa; Lillpopp, Lars; Ojeda, Francisco M; Roth, Alexander; Bickel, Christoph; Baldus, Stephan; Sinning, Christoph R; Wild, Philipp S; Lubos, Edith; Peetz, Dirk; Kunde, Jan; Hartmann, Oliver; Bergmann, Andreas; Post, Felix; Lackner, Karl J; Genth-Zotz, Sabine; Nicaud, Viviane; Tiret, Laurence; Münzel, Thomas F; Blankenberg, Stefan.
in: J AM COLL CARDIOL, Jahrgang 55, Nr. 19, 11.05.2010, S. 2096-2106.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Copeptin improves early diagnosis of acute myocardial infarction
AU - Keller, Till
AU - Tzikas, Stergios
AU - Zeller, Tanja
AU - Czyz, Ewa
AU - Lillpopp, Lars
AU - Ojeda, Francisco M
AU - Roth, Alexander
AU - Bickel, Christoph
AU - Baldus, Stephan
AU - Sinning, Christoph R
AU - Wild, Philipp S
AU - Lubos, Edith
AU - Peetz, Dirk
AU - Kunde, Jan
AU - Hartmann, Oliver
AU - Bergmann, Andreas
AU - Post, Felix
AU - Lackner, Karl J
AU - Genth-Zotz, Sabine
AU - Nicaud, Viviane
AU - Tiret, Laurence
AU - Münzel, Thomas F
AU - Blankenberg, Stefan
N1 - Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2010/5/11
Y1 - 2010/5/11
N2 - OBJECTIVES: Early identification of myocardial infarction in chest pain patients is crucial to identify patients at risk and to maintain a fast treatment initiation.BACKGROUND: The 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.METHODS: Between 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.RESULTS: Of 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%.CONCLUSIONS: In 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.
AB - OBJECTIVES: Early identification of myocardial infarction in chest pain patients is crucial to identify patients at risk and to maintain a fast treatment initiation.BACKGROUND: The 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.METHODS: Between 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.RESULTS: Of 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%.CONCLUSIONS: In 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.
KW - Adult
KW - Aged
KW - Angina Pectoris/blood
KW - Biomarkers/blood
KW - Early Diagnosis
KW - Female
KW - Glycopeptides/blood
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/blood
KW - Myoglobin/blood
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Troponin I/blood
KW - Troponin T/blood
U2 - 10.1016/j.jacc.2010.01.029
DO - 10.1016/j.jacc.2010.01.029
M3 - SCORING: Journal article
C2 - 20447532
VL - 55
SP - 2096
EP - 2106
JO - J AM COLL CARDIOL
JF - J AM COLL CARDIOL
SN - 0735-1097
IS - 19
ER -