Diagnostic performance of copeptin in patients with acute nontraumatic chest pain: BWH-TIMI ED chest pain study.

摘要: Background Arginine-vasopressin (AVP) is an acute marker of physiologic stress. Copeptin the C-terminal fragment vasopressin precursor hormone that more easily measured than AVP. Studies assessing utility copeptin in diagnosis myocardial infarction (MI) have demonstrated mixed results. Hypothesis The aim this study was to test hypothesis improves diagnostic performance when added troponin for detecting MI patients presenting emergency department with nontraumatic chest pain. Methods We copeptin, local cardiac I (local cTnI), and a contemporary sensitive (sensitive cTnI) at presentation serially who presented pain. A cutoff 14 pmol/L utilized. Results MI diagnosed 25.7% patients. Noncoronary cardiopulmonary causes pain occurred 12.8%. Patients had significantly higher levels noncardiac (P < 0.001). The area under receiver operating characteristic curve (AUC) 0.60 (95% confidence interval: 0.54-0.66), less AUC cTnI (0.92) or (0.96). combination either assay (c-statistics 0.92 0.95, respectively) did not improve as compared alone. This finding persisted subgroup early presenters (≤6 hours from symptom onset). Conclusions Copeptin used alone assay, though our cohort relatively few presenters.