• Koen Nieman, Pleunie P M Rood, Admir Dedic, Gert-Jan Ten Kate, Tjebbe W Galema, Mohamed Ouhlous, Adriaan Moelker, Pim J de Feyter, Yolanda B de Rijke, and Gert-Jan ten Kate.
• Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
• Emerg Med J. 2013 Nov 1;30(11):910-3.

ObjectiveTo 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).MethodsCopeptin 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.ResultsThe 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.ConclusionsCopeptin seems to be elevated in patients with ACS while there is no strong correlation with obstructive coronary disease on CTA.

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