PMID- 34481261
OWN - NLM
STAT- MEDLINE
DCOM- 20211228
LR  - 20211228
IS  - 1532-8171 (Electronic)
IS  - 0735-6757 (Linking)
VI  - 50
DP  - 2021 Dec
TI  - The additive value of copeptin for early diagnosis and prognosis of acute 
      coronary syndromes.
PG  - 413-421
LID - S0735-6757(21)00709-9 [pii]
LID - 10.1016/j.ajem.2021.08.069 [doi]
AB  - BACKGROUND: One promising biomarker that has received substantial interest for 
      the evaluation of suspected acute coronary syndromes (ACS) is copeptin. 
      Therefore, our goal was to assess the additive value of copeptin for early 
      diagnosis and prognosis of Non-ST segment acute coronary syndromes (NSTE-ACS). 
      METHODS: The study included ninety patients with suspected ACS. Patients with 
      typical ischemic chest pain within six hours of symptom onset and without 
      ST-segment elevation on electrocardiograph (ECG) were included. In addition to 
      cardiac troponin I (cTnI), copeptin was assayed from venous blood samples 
      obtained on admission, followed by serial troponin measurements six and twelve 
      hours later. One year follow-up was performed for any major adverse cardiac 
      events (MACEs) including cardiac death, re-infarction, re- hospitalization for 
      ischemic events, heart failure, stroke and target lesion revascularization (TLR). 
      RESULTS: Of seventy nine patients included in the final analysis, Forty (50.6%) 
      were diagnosed as unstable angina (UA), while thirty nine (49.4%) had a non-ST 
      elevation myocardial infarction (NSTEMI). Copeptin level on admission was 
      significantly higher among NSTEMI patients than those with UA. With regard to the 
      correlation analyses, copeptin was positively correlated with each of, Global 
      Registry of Acute Coronary Events (GRACE), Thrombolysis In Myocardial Infarction 
      (TIMI) and synergy between percutaneous coronary intervention with taxus and 
      cardiac surgery (SYNTAX) scores. The sensitivity and negative predictive value 
      (NPV) of the combination of admission copeptin and cTn-I were 100% and 100%, 
      respectively, versus 57% and 70%, respectively, with admission of cTn-I alone. 
      The area under curve (AUC) of the combination of copeptin and cTn-I was (0.975, 
      p < 0.001) and was significantly higher than the AUC of cTn-I alone (0.888, 
      p < 0.001). Admission copeptin was an independent predictor for MACEs by multiple 
      regression analysis (OR: 0.01, 95% CI: 0.0-0.8, P = 0.04). High values of 
      copeptin had the highest rate of MACEs and coronary revascularization during one 
      year of follow up. CONCLUSION: The combination of copeptin and conventional 
      troponin I aids in early rule out of NSTEMI virtually independent of chest pain 
      onset (CPO) with high NPV in patients presenting within three hours from chest 
      pain onset with excellent prognostic value for risk stratification and prediction 
      of MACEs.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Ahmed, Tarek A N
AU  - Ahmed TAN
AD  - Cardiology Department, Assiut University Heart Hospital, Egypt.
FAU - Johny, John S
AU  - Johny JS
AD  - Cardiology Department, Assiut University Heart Hospital, Egypt. Electronic 
      address: Johnsafwatjohny91@yahoo.com.
FAU - Abdel-Malek, Mohamed Y
AU  - Abdel-Malek MY
AD  - Clinical Pathology Department, Assiut University Hospital, Egypt.
FAU - Fouad, Doaa A
AU  - Fouad DA
AD  - Cardiology Department, Assiut University Heart Hospital, Egypt.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20210830
PL  - United States
TA  - Am J Emerg Med
JT  - The American journal of emergency medicine
JID - 8309942
RN  - 0 (Biomarkers)
RN  - 0 (Glycopeptides)
RN  - 0 (Troponin)
RN  - 0 (copeptins)
SB  - IM
MH  - Acute Coronary Syndrome/*diagnosis
MH  - Biomarkers/blood
MH  - Early Diagnosis
MH  - Electrocardiography
MH  - Female
MH  - Glycopeptides/*blood
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Prospective Studies
MH  - Troponin/blood
OTO - NOTNLM
OT  - Acute coronary syndrome
OT  - Cardiac troponin I
OT  - Copeptin
COIS- Declaration of Competing Interest None
EDAT- 2021/09/05 06:00
MHDA- 2021/12/29 06:00
CRDT- 2021/09/04 20:23
PHST- 2021/06/16 00:00 [received]
PHST- 2021/08/21 00:00 [revised]
PHST- 2021/08/24 00:00 [accepted]
PHST- 2021/09/05 06:00 [pubmed]
PHST- 2021/12/29 06:00 [medline]
PHST- 2021/09/04 20:23 [entrez]
AID - S0735-6757(21)00709-9 [pii]
AID - 10.1016/j.ajem.2021.08.069 [doi]
PST - ppublish
SO  - Am J Emerg Med. 2021 Dec;50:413-421. doi: 10.1016/j.ajem.2021.08.069. Epub 2021 
      Aug 30.