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अमूर्त

The Clinical Value of Copeptin in Acute Coronary Syndrome

Nora M Aborehab, Tarek M Salman, Ola S Mohamed, Abdel Rahman H El Boquiry and Manal A Mohamed

(1) The introduction of a novel immunoassay measuring copeptin, the c-terminal part of the vasopressin prohormone provided a unique window in common medical disorder. We examined the ability of copeptin in combination with cardiac troponin-I (cTn-I) in diagnosis of AMI, the differentiation between AMI and UA and finally evaluate the ability of copeptin in enhancing sensitivity of cTn-I at early hours of admission in emergency department.

(2) This study was carried on 50 subjects; they were divided into 33 patients with AMI and 17 patients with UA. Concentrations of copeptin, cTn-I and CK-MB were determined in their sera.

(3) In AMI group, the mean serum level of copeptin was highly significant in three hours than admission time and six hours. The mean serum level of cTn-I was highly significant in six hours than the admission time and three hours. The sensitivity and specificity of copeptin and cTn-I combination were 100% and 100% at the admission time versus 72.7% and 82.4% with cTn-I alone also versus 97% and 94.1% with combination of cTn-I and CK-MB. The AUC of the combination of copeptin and cTn-I was 1 which was significantly higher than the AUC of cTn-I alone 0.81 and the AUC of combination of cTn-I and CK-MB 0.92

(4) Copeptin as a single marker has diagnostic value being superior to cTn-I within the first three hours after acute chest pain. Dual marker strategy combining cTn-I and copeptin show incremental value in the early rule out of AMI.