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Endogenous stress response in Tako-Tsubo cardiomyopathy and acute myocardial infarction

Meissner, Julia and Nef, Holger and Darga, Joelyn and Kovacs, Maria and Weber, Michael and Hamm, Christian and Möllmann, Helge and Twerenbold, Raphael and Reiter, Miriam and Heinisch, Corinna and Stelzig, Claudia and Reichlin, Tobias and Mueller, Christian. (2011) Endogenous stress response in Tako-Tsubo cardiomyopathy and acute myocardial infarction. European Journal of Clinical Investigation, Vol. 41, H. 9. pp. 964-970.

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Official URL: http://edoc.unibas.ch/dok/A5843836

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Abstract

Eur J Clin Invest 2011 ABSTRACT: Background? As the clinical, electrocardiographic and laboratory presentation of Tako-Tsubo cardiomyopathy (TTC) and acute myocardial infarction (AMI) is similar, both entities are in general only distinguishable by coronary angiography. The purpose of this study was to examine the endogenous stress response at presentation, quantified by the copeptin level, of patients with TTC and patients with AMI, as copeptin may be useful in the non-invasive differentiation between both diseases. Methods? We compared the endogenous stress response at initial presentation, quantified by the plasma copeptin levels, in 21 consecutive patients finally diagnosed with TTC and 21 patients finally diagnosed with AMI matched for sex and time since chest pain onset. Results? The prevalence of cardiovascular risk factors and initial cardiac troponin T levels were comparable in TTC and AMI. Copeptin levels were significantly lower in patients with TTC when compared to patients with AMI (median 4·8 [interquartile range, IQR 3·5-13·5] pM vs. 25·6 [IQR 12·1-63·9] pM, P?=?0·002). The accuracy for diagnosing TTC as quantified by the area under the receiver operating characteristics curve was significantly higher for copeptin than for cardiac troponin T (0·782 vs. 0·549, P?=?0·031). The optimal cut-off value for differentiation between TTC and AMI was found at a copeptin level of 7·8?pM (sensitivity 67% at a specificity of 86%, negative predictive value 72%, positive predictive value 82%). Conclusions? The endogenous stress response, quantified by a novel sensitive biomarker, seems to be different in patients with TTC and AMI. Copeptin levels may be helpful in the non-invasive differentiation between TTC and AMI.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie
UniBasel Contributors:Reichlin, Tobias
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Wiley
ISSN:0014-2972
e-ISSN:1365-2362
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:13 Oct 2017 08:27
Deposited On:08 Jun 2012 06:42

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