Endogenous stress response in Tako-Tsubo cardiomyopathy and acute myocardial infarction
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Endogenous stress response in Tako-Tsubo cardiomyopathy and acute myocardial infarction. / Meissner, Julia; Nef, Holger; Darga, Joelyn; Kovacs, Maria; Weber, Michael; Hamm, Christian; Möllmann, Helge; Twerenbold, Raphael; Reiter, Miriam; Heinisch, Corinna; Stelzig, Claudia; Reichlin, Tobias; Mueller, Christian.
in: EUR J CLIN INVEST, Jahrgang 41, Nr. 9, 09.2011, S. 964-970.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Endogenous stress response in Tako-Tsubo cardiomyopathy and acute myocardial infarction
AU - Meissner, Julia
AU - Nef, Holger
AU - Darga, Joelyn
AU - Kovacs, Maria
AU - Weber, Michael
AU - Hamm, Christian
AU - Möllmann, Helge
AU - Twerenbold, Raphael
AU - Reiter, Miriam
AU - Heinisch, Corinna
AU - Stelzig, Claudia
AU - Reichlin, Tobias
AU - Mueller, Christian
PY - 2011/9
Y1 - 2011/9
N2 - Background As the clinical, electrocardiographic and laboratory presentation of Tako-Tsubo cardiomyopathy (TTC) and acute myocardial infarction (AMI) is similar, both entities are in general only distinguishable by coronary angiography. The purpose of this study was to examine the endogenous stress response at presentation, quantified by the copeptin level, of patients with TTC and patients with AMI, as copeptin may be useful in the non-invasive differentiation between both diseases. Methods We compared the endogenous stress response at initial presentation, quantified by the plasma copeptin levels, in 21 consecutive patients finally diagnosed with TTC and 21 patients finally diagnosed with AMI matched for sex and time since chest pain onset. Results The prevalence of cardiovascular risk factors and initial cardiac troponin T levels were comparable in TTC and AMI. Copeptin levels were significantly lower in patients with TTC when compared to patients with AMI (median 4·8 [interquartile range, IQR 3·5-13·5] pM vs. 25·6 [IQR 12·1-63·9] pM, P=0·002). The accuracy for diagnosing TTC as quantified by the area under the receiver operating characteristics curve was significantly higher for copeptin than for cardiac troponin T (0·782 vs. 0·549, P=0·031). The optimal cut-off value for differentiation between TTC and AMI was found at a copeptin level of 7·8pM (sensitivity 67% at a specificity of 86%, negative predictive value 72%, positive predictive value 82%). Conclusions The endogenous stress response, quantified by a novel sensitive biomarker, seems to be different in patients with TTC and AMI. Copeptin levels may be helpful in the non-invasive differentiation between TTC and AMI.
AB - Background As the clinical, electrocardiographic and laboratory presentation of Tako-Tsubo cardiomyopathy (TTC) and acute myocardial infarction (AMI) is similar, both entities are in general only distinguishable by coronary angiography. The purpose of this study was to examine the endogenous stress response at presentation, quantified by the copeptin level, of patients with TTC and patients with AMI, as copeptin may be useful in the non-invasive differentiation between both diseases. Methods We compared the endogenous stress response at initial presentation, quantified by the plasma copeptin levels, in 21 consecutive patients finally diagnosed with TTC and 21 patients finally diagnosed with AMI matched for sex and time since chest pain onset. Results The prevalence of cardiovascular risk factors and initial cardiac troponin T levels were comparable in TTC and AMI. Copeptin levels were significantly lower in patients with TTC when compared to patients with AMI (median 4·8 [interquartile range, IQR 3·5-13·5] pM vs. 25·6 [IQR 12·1-63·9] pM, P=0·002). The accuracy for diagnosing TTC as quantified by the area under the receiver operating characteristics curve was significantly higher for copeptin than for cardiac troponin T (0·782 vs. 0·549, P=0·031). The optimal cut-off value for differentiation between TTC and AMI was found at a copeptin level of 7·8pM (sensitivity 67% at a specificity of 86%, negative predictive value 72%, positive predictive value 82%). Conclusions The endogenous stress response, quantified by a novel sensitive biomarker, seems to be different in patients with TTC and AMI. Copeptin levels may be helpful in the non-invasive differentiation between TTC and AMI.
KW - Acute myocardial infarction
KW - Cardiomyopathy
KW - Copeptin
KW - Stress
UR - http://www.scopus.com/inward/record.url?scp=79960986857&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2362.2011.02487.x
DO - 10.1111/j.1365-2362.2011.02487.x
M3 - SCORING: Journal article
C2 - 21391994
AN - SCOPUS:79960986857
VL - 41
SP - 964
EP - 970
JO - EUR J CLIN INVEST
JF - EUR J CLIN INVEST
SN - 0014-2972
IS - 9
ER -
