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Copeptin in acute chest pain: identification of acute coronary syndrome and obstructive coronary artery disease on coronary CT angiography
  1. Admir Dedic1,2,
  2. Gert-Jan ten Kate1,2,
  3. Pleunie P M Rood3,
  4. Tjebbe W Galema1,
  5. Mohamed Ouhlous2,
  6. Adriaan Moelker2,
  7. Pim J de Feyter1,2,
  8. Yolanda B de Rijke4,
  9. Koen Nieman1,2
  1. 1Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands
  2. 2Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands
  3. 3Department of Emergency Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
  4. 4Department of Clinical Chemistry, Erasmus Medical Centre, Rotterdam, The Netherlands
  1. Correspondence to Admir Dedic, Department of Cardiology, Erasmus Medical Centre, 's-Gravendijkwal 230, PO Box 2040, Rotterdam 3000 CA, The Netherlands; a.dedic{at}erasmusmc.nl

Abstract

Objective To determine the diagnostic accuracy of copeptin in patients with suspected acute coronary syndrome (ACS) and its correlation with obstructive coronary artery disease (CAD) on coronary CT angiography (CTA).

Methods Copeptin was measured at arrival in 65 consecutive patients (56±10 years, 45 men) suspected of ACS and no indication for immediate invasive angiography. All patients underwent coronary CTA without disclosure of the results to the treating physician, and outcomes were classified as obstructive CAD (>50% stenosis) or no obstructive CAD (≤50%) in one or more vessel.

Results The final diagnosis of ACS was established in 10 (15%) patients, 6 myocardial infarctions and 4 unstable angina pectoris. Coronary CTA detected obstructive CAD in all patients with ACS and in 10 (15%) patients with no ACS. Copeptin concentrations were higher in patients with ACS (median 7.42 pmol/l (IQR 3.71–18.72)) vs patients with no ACS (3.40 pmol/l (1.13–6.27), p=0.02). Copeptin was not higher in patients with obstructive CAD on coronary CTA (4.87 pmol/l (2.90–8.51) vs 3.60 pmol/l (1.21–6.23), p=0.20) compared with patients with no obstructive CAD.

Conclusions Copeptin seems to be elevated in patients with ACS while there is no strong correlation with obstructive coronary disease on CTA.

  • acute coronary syndrome
  • imaging, CT/MRI
  • cardiac care, diagnosis
  • emergency departments

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