RT Journal Article
SR Electronic
T1 Copeptin in acute chest pain: identification of acute coronary syndrome and obstructive coronary artery disease on coronary CT angiography
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 910
OP 913
DO 10.1136/emermed-2012-201596
VO 30
IS 11
A1 Dedic, Admir
A1 ten Kate, Gert-Jan
A1 Rood, Pleunie P M
A1 Galema, Tjebbe W
A1 Ouhlous, Mohamed
A1 Moelker, Adriaan
A1 de Feyter, Pim J
A1 de Rijke, Yolanda B
A1 Nieman, Koen
YR 2013
UL http://emj.bmj.com/content/30/11/910.abstract
AB 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.