PMID- 36262786
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231002
IS  - 0970-1915 (Print)
IS  - 0974-0422 (Electronic)
IS  - 0970-1915 (Linking)
VI  - 37
IP  - 4
DP  - 2022 Oct
TI  - Improving the ACS Triage-Using High Sensitivity TroponinI and Copeptin for Early 
      'Rule-Out' of AMI.
PG  - 449-457
LID - 10.1007/s12291-021-01015-7 [doi]
AB  - Rule-out of acute myocardial infarction (AMI) in patients presenting with acute 
      chest pain at the emergency department (ED) is a major challenge across the 
      globe. Patients presenting very early with chest pain may provide a diagnostic 
      challenge even when using a cardiac necrosis specific biomarker, high sensitivity 
      troponin (hs-Tn) as they are elevated at 3-6 h after the symptom onset. Copeptin 
      is a marker of acute hemodynamic stress which is released within few minutes of 
      the occurrence of MI and is elevated immediately at the presentation of patients 
      with AMI. This indicates a complementary pathophysiology and kinetics of these 
      two biomarkers. Hence, we evaluated whether or not a protocol with combined 
      testing of copeptin and hs-TnI at admission in patients presenting with chest 
      pain within 6 h in low to intermediate risk and suspected ACS leads to an earlier 
      diagnosis of AMI and thereby, aids to prevent a higher proportion of major 
      adverse cardiac events than the current standard protocol followed in ED. A total 
      of 148 patients as per the inclusion criterion were recruited for the study. The 
      dual biomarker copeptin and hs-TnI allows a rule-out of AMI at presentation with 
      a sensitivity of 100% and NPV of 99.8%. Hence, the use of dual biomarker in 
      conjunction with clinical assessment may obviate the need for a prolonged stay in 
      the ED and retesting hs-TnI after 2 h (for delta check) in more than two-thirds 
      of the patients. The inclusion of these tests could have an impact on the 
      economic burden of the ED without jeopardizing the outcome for the patient.
CI  - (c) The Author(s), under exclusive licence to Association of Clinical Biochemists 
      of India 2021.
FAU - Kankra, M
AU  - Kankra M
AD  - Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India. 
      GRID: grid.415985.4. ISNI: 0000 0004 1767 8547
FAU - Mehta, A
AU  - Mehta A
AD  - Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India. GRID: 
      grid.415985.4. ISNI: 0000 0004 1767 8547
FAU - Sawhney, J P S
AU  - Sawhney JPS
AD  - Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India. GRID: 
      grid.415985.4. ISNI: 0000 0004 1767 8547
FAU - Solanki, S
AU  - Solanki S
AD  - Department of Emergency Medicine, Sir Ganga Ram Hospital, New Delhi, India. GRID: 
      grid.415985.4. ISNI: 0000 0004 1767 8547
FAU - Bhargava, S
AU  - Bhargava S
AD  - Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India. 
      GRID: grid.415985.4. ISNI: 0000 0004 1767 8547
FAU - Ahirwar, A
AU  - Ahirwar A
AD  - Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India. 
      GRID: grid.415985.4. ISNI: 0000 0004 1767 8547
FAU - Manocha, A
AU  - Manocha A
AD  - Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India. 
      GRID: grid.415985.4. ISNI: 0000 0004 1767 8547
FAU - Singla, P
AU  - Singla P
AD  - Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India. 
      GRID: grid.415985.4. ISNI: 0000 0004 1767 8547
FAU - Sharma, A
AU  - Sharma A
AD  - Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India. 
      GRID: grid.415985.4. ISNI: 0000 0004 1767 8547
FAU - Sharma, M
AU  - Sharma M
AD  - Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India. 
      GRID: grid.415985.4. ISNI: 0000 0004 1767 8547
LA  - eng
PT  - Journal Article
DEP - 20220108
PL  - India
TA  - Indian J Clin Biochem
JT  - Indian journal of clinical biochemistry : IJCB
JID - 8708303
PMC - PMC9573839
OTO - NOTNLM
OT  - Acute coronary syndrome (ACS)
OT  - Acute myocardial infarction (AMI)
OT  - Copeptin
OT  - High sensitivity troponin (hs-Tn)
OT  - Rule-out
EDAT- 2022/10/21 06:00
MHDA- 2022/10/21 06:01
PMCR- 2023/10/01
CRDT- 2022/10/20 02:44
PHST- 2021/07/01 00:00 [received]
PHST- 2021/10/26 00:00 [accepted]
PHST- 2022/10/20 02:44 [entrez]
PHST- 2022/10/21 06:00 [pubmed]
PHST- 2022/10/21 06:01 [medline]
PHST- 2023/10/01 00:00 [pmc-release]
AID - 1015 [pii]
AID - 10.1007/s12291-021-01015-7 [doi]
PST - ppublish
SO  - Indian J Clin Biochem. 2022 Oct;37(4):449-457. doi: 10.1007/s12291-021-01015-7. 
      Epub 2022 Jan 8.