PMID- 21309746
OWN - NLM
STAT- MEDLINE
DCOM- 20110628
LR  - 20220318
IS  - 1470-8736 (Electronic)
IS  - 0143-5221 (Linking)
VI  - 121
IP  - 2
DP  - 2011 Jul
TI  - C-terminal provasopressin (copeptin) as a prognostic marker after acute non-ST 
      elevation myocardial infarction: Leicester Acute Myocardial Infarction Peptide II 
      (LAMP II) study.
PG  - 79-89
LID - 10.1042/CS20100564 [doi]
AB  - Copeptin, the 39-amino-acid C-terminal portion of provasopressin, has been shown 
      to be an independent predictor for adverse events following STEMI (ST elevation 
      myocardial infarction). We hypothesized that plasma copeptin was an independent 
      predictor for adverse outcomes following acute NSTEMI (non-STEMI) and evaluated 
      whether copeptin added prognostic information to the GRACE (Global Registry of 
      Acute Coronary Events) score compared with NT-proBNP (N-terminal pro-B-type 
      natriuretic peptide). Plasma copeptin and NT-proBNP were measured in 754 
      consecutive patients admitted to the hospital with chest pain and diagnosed as 
      having NSTEMI in this prospective observational study. The end point was 
      all-cause mortality at 6 months. Upper median levels of copeptin were strongly 
      associated with all-cause mortality at 6 months. Copeptin was a significant 
      predictor of time to mortality HR (hazard ratio), 5.98 [95% CI (confidence 
      interval, 3.75-9.53]; P < 0.0005 in univariate analysis and remained a 
      significant predictor in multivariate analysis [HR, 3.03 (05% CI, 1.32-6.98); P = 
      0.009]. There were no significant differences between the area under ROC 
      (receiver operating characteristic) curves of copeptin, NT-proBNP and the GRACE 
      score. Copeptin improved accuracy of risk classification when used in combination 
      with the GRACE score as determined by net reclassification improvement, whereas 
      NT-proBNP did not. The relative utility of the GRACE score was increased more by 
      copeptin than by NT-proBNP over a wide range of risks. Plasma copeptin is 
      elevated after NSTEMI, and higher levels are associated with worse outcomes. 
      Copeptin used in conjunction with the GRACE score improves risk stratification 
      enabling more accurate identification of high-risk individuals.
FAU - Narayan, Hafid
AU  - Narayan H
AD  - Department of Cardiovascular Sciences, University of Leicester, Leicester LE2 
      7LX, UK. hn31@le.ac.uk
FAU - Dhillon, Onkar S
AU  - Dhillon OS
FAU - Quinn, Pauline A
AU  - Quinn PA
FAU - Struck, Joachim
AU  - Struck J
FAU - Squire, Iain B
AU  - Squire IB
FAU - Davies, Joan E
AU  - Davies JE
FAU - Ng, Leong L
AU  - Ng LL
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Clin Sci (Lond)
JT  - Clinical science (London, England : 1979)
JID - 7905731
RN  - 0 (Biomarkers)
RN  - 0 (Glycopeptides)
RN  - 0 (Peptide Fragments)
RN  - 0 (copeptins)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers/blood
MH  - England/epidemiology
MH  - Epidemiologic Methods
MH  - Female
MH  - Glycopeptides/*blood
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/blood/*diagnosis/mortality
MH  - Natriuretic Peptide, Brain/blood
MH  - Peptide Fragments/blood
MH  - Prognosis
EDAT- 2011/02/12 06:00
MHDA- 2011/06/29 06:00
CRDT- 2011/02/12 06:00
PHST- 2011/02/12 06:00 [entrez]
PHST- 2011/02/12 06:00 [pubmed]
PHST- 2011/06/29 06:00 [medline]
AID - CS20100564 [pii]
AID - 10.1042/CS20100564 [doi]
PST - ppublish
SO  - Clin Sci (Lond). 2011 Jul;121(2):79-89. doi: 10.1042/CS20100564.