Prevalence, characteristics and outcome of non-cardiac chest pain and elevated Copeptin levels
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Prevalence, characteristics and outcome of non-cardiac chest pain and elevated Copeptin levels. / Stallone, Fabio; Twerenbold, Raphael; Wildi, Karin; Reichlin, Tobias; Gimenez, Maria Rubini; Haaf, Philip; Fuechslin, Nicole; Hillinger, Petra; Jaeger, Cedric; Kreutzinger, Philipp; Puelacher, Christian; Radosavac, Milos; Weidmann, Zoraida Moreno; Moehring, Berit; Honegger, Ursina; Schumacher, Carmela; Denhaerynck, Kris; Arnold, Christiane; Bingisser, Roland; Vollert, Jörn Ole; Osswald, Stefan; Mueller, Christian.
In: HEART, Vol. 100, No. 21, 01.11.2014, p. 1708-1714.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Prevalence, characteristics and outcome of non-cardiac chest pain and elevated Copeptin levels
AU - Stallone, Fabio
AU - Twerenbold, Raphael
AU - Wildi, Karin
AU - Reichlin, Tobias
AU - Gimenez, Maria Rubini
AU - Haaf, Philip
AU - Fuechslin, Nicole
AU - Hillinger, Petra
AU - Jaeger, Cedric
AU - Kreutzinger, Philipp
AU - Puelacher, Christian
AU - Radosavac, Milos
AU - Weidmann, Zoraida Moreno
AU - Moehring, Berit
AU - Honegger, Ursina
AU - Schumacher, Carmela
AU - Denhaerynck, Kris
AU - Arnold, Christiane
AU - Bingisser, Roland
AU - Vollert, Jörn Ole
AU - Osswald, Stefan
AU - Mueller, Christian
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Objective: Copeptin, a quantitative marker of endogenous stress, seems to provide incremental value in addition to cardiac troponin in the early rule-out of acute myocardial infarction (AMI). Prevalence, characteristics and outcome of acute chest pain patients with causes other than AMI and elevated copeptin are poorly understood.Methods: A total of 984 consecutive patients with non-cardiac chest pain were selected from a prospective multicentre study of acute chest pain patients presenting to the emergency department. Levels of copeptin were determined in a blinded fashion and considered elevated if above 13 pmol/L (the 97,5th centile of healthy individuals). The final diagnosis was adjudicated by two independent cardiologists. Median duration of follow-up was 756 days.Results: Elevated copeptin levels were seen in 215 patients (22%). In comparison to patients with normal copeptin levels, patients with elevated levels were older, had more pre-existing cardiac and non-cardiac disorders, more silent cardiomyocyte injury and increased haemodynamic stress as quantified by levels of highsensitivity cardiac troponin T (9.6 ng/L (3.6-18.3) vs 5.8 ng/L (2.9-9.4)) and B-type natriuretic peptide (75 ng/L (37-187) vs 35 ng/L (15-77)) (both p<0.001), more electrocardiographic abnormalities, more often an adjudicated diagnosis of gastroesophageal reflux or bronchitis/pneumonia and higher 2-year mortality (HR 2.9, 95% CI 1.5 to 5.7). The increased mortality rate seemed to be largely explained by age and comorbidities.Conclusions: Elevated levels of copeptin are present in about one in five patients with non-cardiac chest pain and are associated with aging, cardiac and non-cardiac comorbidities as well as mortality.
AB - Objective: Copeptin, a quantitative marker of endogenous stress, seems to provide incremental value in addition to cardiac troponin in the early rule-out of acute myocardial infarction (AMI). Prevalence, characteristics and outcome of acute chest pain patients with causes other than AMI and elevated copeptin are poorly understood.Methods: A total of 984 consecutive patients with non-cardiac chest pain were selected from a prospective multicentre study of acute chest pain patients presenting to the emergency department. Levels of copeptin were determined in a blinded fashion and considered elevated if above 13 pmol/L (the 97,5th centile of healthy individuals). The final diagnosis was adjudicated by two independent cardiologists. Median duration of follow-up was 756 days.Results: Elevated copeptin levels were seen in 215 patients (22%). In comparison to patients with normal copeptin levels, patients with elevated levels were older, had more pre-existing cardiac and non-cardiac disorders, more silent cardiomyocyte injury and increased haemodynamic stress as quantified by levels of highsensitivity cardiac troponin T (9.6 ng/L (3.6-18.3) vs 5.8 ng/L (2.9-9.4)) and B-type natriuretic peptide (75 ng/L (37-187) vs 35 ng/L (15-77)) (both p<0.001), more electrocardiographic abnormalities, more often an adjudicated diagnosis of gastroesophageal reflux or bronchitis/pneumonia and higher 2-year mortality (HR 2.9, 95% CI 1.5 to 5.7). The increased mortality rate seemed to be largely explained by age and comorbidities.Conclusions: Elevated levels of copeptin are present in about one in five patients with non-cardiac chest pain and are associated with aging, cardiac and non-cardiac comorbidities as well as mortality.
UR - http://www.scopus.com/inward/record.url?scp=84922061403&partnerID=8YFLogxK
U2 - 10.1136/heartjnl-2014-305583
DO - 10.1136/heartjnl-2014-305583
M3 - SCORING: Journal article
C2 - 24968886
AN - SCOPUS:84922061403
VL - 100
SP - 1708
EP - 1714
JO - HEART
JF - HEART
SN - 1355-6037
IS - 21
ER -