PURPOSE: The main objective of this multicentric study was to evaluate the additional value of copeptin to conventional cardiac troponin (cTn) for a rapid ruling out of acute myocardial infarction (AMI) in patients with acute chest pain and a previous history of coronary artery disease (CAD). PATIENTS AND METHOD: Patients with a previous history of CAD presenting in the emergency department with acute chest pain lasting for 6 hours or less suggestive of non-ST-segment elevation AMI and negative cTn were selected. Levels of copeptin were blindly measured at presentation. The diagnosis was adjudicated by 2 independent experts using all available data including cTn. RESULTS: A total of 451 patients were included (mean age, 67±14; 330 [73%] men). The adjudicated final diagnosis was AMI in 36 (8%) patients, unstable angina in 131 (29%), and other diagnosis in 284 (63%). A negative cTn combined with a copeptin value lower than 10.7 pmol/L at presentation was able to rule out AMI, with a negative predictive value of 98% (95% confidence interval, 95%-99%). CONCLUSION: In triage patients with acute chest pain lasting for less than 6 hours and a previous history of CAD, the combination of copeptin and cTn allows for the ruling out AMI, with a negative predictive value greater than 95%.
PURPOSE: The main objective of this multicentric study was to evaluate the additional value of copeptin to conventional cardiac troponin (cTn) for a rapid ruling out of acute myocardial infarction (AMI) in patients with acute chest pain and a previous history of coronary artery disease (CAD). PATIENTS AND METHOD:Patients with a previous history of CAD presenting in the emergency department with acute chest pain lasting for 6 hours or less suggestive of non-ST-segment elevation AMI and negative cTn were selected. Levels of copeptin were blindly measured at presentation. The diagnosis was adjudicated by 2 independent experts using all available data including cTn. RESULTS: A total of 451 patients were included (mean age, 67±14; 330 [73%] men). The adjudicated final diagnosis was AMI in 36 (8%) patients, unstable angina in 131 (29%), and other diagnosis in 284 (63%). A negative cTn combined with a copeptin value lower than 10.7 pmol/L at presentation was able to rule out AMI, with a negative predictive value of 98% (95% confidence interval, 95%-99%). CONCLUSION: In triage patients with acute chest pain lasting for less than 6 hours and a previous history of CAD, the combination of copeptin and cTn allows for the ruling out AMI, with a negative predictive value greater than 95%.
Authors: Anna Wyzgał; Marcin Koć; Szymon Pacho; Maksymilian Bielecki; Radosław Wawrzyniak; Maciej Kostrubiec; Michał Ciurzyński; Katarzyna Kurnicka; Sylwia Goliszek; Marzena Paczyńska; Piotr Palczewski; Piotr Pruszczyk Journal: J Thromb Thrombolysis Date: 2016-05 Impact factor: 2.300
Authors: Sebastian Johannes Reinstadler; Gert Klug; Hans-Josef Feistritzer; Bernhard Metzler; Johannes Mair Journal: Dis Markers Date: 2015-04-16 Impact factor: 3.434
Authors: Martin Möckel; Julia Searle; Christian Hamm; Anna Slagman; Stefan Blankenberg; Kurt Huber; Hugo Katus; Christoph Liebetrau; Christian Müller; Reinhold Muller; Philipp Peitsmeyer; Johannes von Recum; Milos Tajsic; Jörn O Vollert; Evangelos Giannitsis Journal: Eur Heart J Date: 2014-04-30 Impact factor: 29.983