OBJECTIVES: Early identification of myocardial infarction in chest pain patients is crucial to identify patients at risk and to maintain a fast treatment initiation. BACKGROUND: The aim of the current investigation is to test whether determination of copeptin, an indirect marker for arginin-vasopressin, adds diagnostic information to cardiac troponin in early evaluation of patients with suspected myocardial infarction. METHODS: Between January 2007 and July 2008, patients with suspected acute coronary syndrome were consecutively enrolled in this multicenter study. Copeptin, troponin T (TnT), myoglobin, and creatine kinase-myocardial band were determined at admission and after 3 and 6 h. RESULTS: Of 1,386 (66.4% male) enrolled patients, 299 (21.6%) had the discharge diagnosis of acute myocardial infarction, 184 (13.3%) presented with unstable angina, and in 903 (65.2%) an acute coronary syndrome could be excluded. Combined measurement of copeptin and TnT on admission improved the c-statistic from 0.84 for TnT alone to 0.93 in the overall population and from 0.77 to 0.9 in patients presenting within 3 h after chest pain onset (CPO) (p < 0.001). In this group the combination of copeptin with a conventional TnT provided a negative predictive value of 92.4%. CONCLUSIONS: In triage of chest pain patients, determination of copeptin in addition to troponin improves diagnostic performance, especially early after CPO. Combined determination of troponin and copeptin provides a remarkable negative predictive value virtually independent of CPO time and therefore aids in early and safe rule-out of myocardial infarction. Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
OBJECTIVES: Early identification of myocardial infarction in chest painpatients is crucial to identify patients at risk and to maintain a fast treatment initiation. BACKGROUND: The aim of the current investigation is to test whether determination of copeptin, an indirect marker for arginin-vasopressin, adds diagnostic information to cardiac troponin in early evaluation of patients with suspected myocardial infarction. METHODS: Between January 2007 and July 2008, patients with suspected acute coronary syndrome were consecutively enrolled in this multicenter study. Copeptin, troponin T (TnT), myoglobin, and creatine kinase-myocardial band were determined at admission and after 3 and 6 h. RESULTS: Of 1,386 (66.4% male) enrolled patients, 299 (21.6%) had the discharge diagnosis of acute myocardial infarction, 184 (13.3%) presented with unstable angina, and in 903 (65.2%) an acute coronary syndrome could be excluded. Combined measurement of copeptin and TnT on admission improved the c-statistic from 0.84 for TnT alone to 0.93 in the overall population and from 0.77 to 0.9 in patients presenting within 3 h after chest pain onset (CPO) (p < 0.001). In this group the combination of copeptin with a conventional TnT provided a negative predictive value of 92.4%. CONCLUSIONS: In triage of chest painpatients, determination of copeptin in addition to troponin improves diagnostic performance, especially early after CPO. Combined determination of troponin and copeptin provides a remarkable negative predictive value virtually independent of CPO time and therefore aids in early and safe rule-out of myocardial infarction. Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Authors: Jasper Boeddinghaus; Tobias Reichlin; Thomas Nestelberger; Raphael Twerenbold; Yvette Meili; Karin Wildi; Petra Hillinger; Maria Rubini Giménez; Janosch Cupa; Lukas Schumacher; Marie Schubera; Patrick Badertscher; Sydney Corbière; Karin Grimm; Christian Puelacher; Zaid Sabti; Dayana Flores Widmer; Nicolas Schaerli; Nikola Kozhuharov; Samyut Shrestha; Tobias Bürge; Patrick Mächler; Michael Büchi; Katharina Rentsch; Òscar Miró; Beatriz López; F Javier Martin-Sanchez; Esther Rodriguez-Adrada; Beata Morawiec; Damian Kawecki; Eva Ganovská; Jiri Parenica; Jens Lohrmann; Andreas Buser; Dagmar I Keller; Stefan Osswald; Christian Mueller Journal: Clin Res Cardiol Date: 2017-02-01 Impact factor: 5.460
Authors: Tobias Reichlin; Raphael Twerenbold; Karin Wildi; Maria Rubini Gimenez; Nathalie Bergsma; Philip Haaf; Sophie Druey; Christian Puelacher; Berit Moehring; Michael Freese; Claudia Stelzig; Lian Krivoshei; Petra Hillinger; Cedric Jäger; Thomas Herrmann; Philip Kreutzinger; Milos Radosavac; Zoraida Moreno Weidmann; Kateryna Pershyna; Ursina Honegger; Max Wagener; Thierry Vuillomenet; Isabel Campodarve; Roland Bingisser; Òscar Miró; Katharina Rentsch; Stefano Bassetti; Stefan Osswald; Christian Mueller Journal: CMAJ Date: 2015-04-13 Impact factor: 8.262