• Medicina intensiva · Nov 2015

    Observational Study

    Usefulness of copeptin in discarding non-ST elevation acute myocardial infarction in patients with acute chest pain and negative first troponin I.

    • P Esteban-Torrella, L García de Guadiana-Romualdo, L Consuegra-Sánchez, D Dau-Villarreal, A Melgarejo-Moreno, M D Albaladejo-Otón, and M Villegas-García.
    • Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, España.
    • Med Intensiva. 2015 Nov 1; 39 (8): 477-82.

    AimTo evaluate the usefulness of copeptin as a rapid and reliable marker for discarding non-ST elevation acute myocardial infarction (NSTEMI) in patients attended in an Emergency Care Department due to acute chest pain with a normal or non-diagnostic electrocardiogram and a negative first troponin I result.DesignA prospective observational study was carried out.SettingThe Emergency Care Department of a university hospital.PatientsThe study comprised a total of 97 patients attended in the Emergency Care Department due to chest pain suggestive of acute coronary syndrome with an evolution of under 12h, a non-diagnostic electrocardiogram and a negative first troponin I result.InterventionsNone.Variables Of InterestPatient demographic data and baseline characteristics, copeptin upon admission, troponin I upon admission and after 6h, and final diagnosis.ResultsThe final diagnosis was NSTEMI in 14 patients (14.4%) -no significant differences in copeptin concentration being observed between the 2 groups, though a tendency towards higher values was recorded in the NSTEMI group (median: 24.6pmol/l [interquartile range: 42.0] vs. 12.0pmol/l [16.1]; P=.06). The AUC ROC for copeptin upon admission was 0.657 (95%CI: 0.504-0.810), with a negative predictive value of 92% for a cutoff point of 14pmol/l.ConclusionsCopeptin determination upon admission to the Emergency Care Department in patients with chest pain for ≤12h, suggestive of acute coronary syndrome, with a non-diagnostic electrocardiogram and a negative first troponin I determination does not allow rapid and reliable exclusion of the presence of NSTEMI. Serial troponin I measurements are needed in this respect.Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

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