edoc

Incremental value of copeptin for rapid rule out of acute myocardial infarction

Reichlin, Tobias and Hochholzer, Willibald and Stelzig, Claudia and Laule, Kirsten and Freidank, Heike and Morgenthaler, Nils G. and Bergmann, Andreas and Potocki, Mihael and Noveanu, Markus and Breidthardt, Tobias and Christ, Andreas and Boldanova, Tujana and Merki, Ramona and Schaub, Nora and Bingisser, Roland and Christ, Michael and Mueller, Christian. (2009) Incremental value of copeptin for rapid rule out of acute myocardial infarction. Journal of the American College of Cardiology, Vol. 54, H. 1. pp. 60-68.

Full text not available from this repository.

Official URL: http://edoc.unibas.ch/dok/A5843861

Downloads: Statistics Overview

Abstract

The purpose of this study was to examine the incremental value of copeptin for rapid rule out of acute myocardial infarction (AMI).; The rapid and reliable exclusion of AMI is a major unmet clinical need. Copeptin, the C-terminal part of the vasopressin prohormone, as a marker of acute endogenous stress may be useful in this setting.; In 487 consecutive patients presenting to the emergency department with symptoms suggestive of AMI, we measured levels of copeptin at presentation, using a novel sandwich immunoluminometric assay in a blinded fashion. The final diagnosis was adjudicated by 2 independent cardiologists using all available data.; The adjudicated final diagnosis was AMI in 81 patients (17%). Copeptin levels were significantly higher in AMI patients compared with those in patients having other diagnoses (median 20.8 pmol/l vs. 6.0 pmol/l, p > 0.001). The combination of troponin T and copeptin at initial presentation resulted in an area under the receiver-operating characteristic curve of 0.97 (95% confidence interval: 0.95 to 0.98), which was significantly higher than the 0.86 (95% confidence interval: 0.80 to 0.92) for troponin T alone (p > 0.001). A copeptin level >14 pmol/l in combination with a troponin T > or =0.01 microg/l correctly ruled out AMI with a sensitivity of 98.8% and a negative predictive value of 99.7%.; The additional use of copeptin seems to allow a rapid and reliable rule out of AMI already at presentation and may thereby obviate the need for prolonged monitoring and serial blood sampling in the majority of patients. (Advantageous Predictors of Acute Coronary Syndromes Evaluation [APACE]; NCT00470587).
Faculties and Departments:03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Labormedizin
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Labormedizin
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Stationäre innere Medizin (Schifferli)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Stationäre innere Medizin (Schifferli)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie
UniBasel Contributors:Bingisser, Roland M. and Müller, Christian and Freidank, Heike and Reichlin, Tobias
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Elsevier
ISSN:0735-1097
Note:Publication type according to Uni Basel Research Database: Journal article
Related URLs:
Identification Number:
Last Modified:04 Jan 2013 08:37
Deposited On:08 Jun 2012 06:43

Repository Staff Only: item control page