Clinical Utility of Serum Copeptin in Patients with Acute Coronary Syndrome

Abstract

(1) The introduction of a novel immunoassay measuring Copeptin, the c-terminal part of the vasopressin prohormone provided a unique window in common medical disorder. We examined the ability of Copeptin in combination with cardiac troponin-I (cTn-I) in diagnosis of AMI, the differentiation between AMI and UA and finally evaluate the ability of Copeptin in enhancing sensitivity of cTn-I at early hours of admission in emergency department. (2) This study was carried on 50 subjects; they were divided into 25 patients with AMI and15 patients with UA in addition to 10 healthy subjects serving as healthy control. Concentrations of Copeptin, cTn-I and CK-MB were determined in their sera. (3) In AMI group, the mean serum level of Copeptin was highly significant in three hours than six hours from admission time. The mean serum level of cTn-I was highly significant in six hours than three hours. The sensitivity and specificity of Copeptinwere 100% and 100% at 3 hours from the admission time versus 92% and 46.67% with cTn-I. The AUC of the combination ofCopeptin was 1 which was significantly higher than the AUC of cTn-I 0.669. (4) Copeptin as a single marker has diagnostic value being superior to cTn-I within the first three hours after acute chest pain but still single Copeptin determination is unable to displace or challenge a serial cTnI measurement to detect myocardial necrosis within a rule in approach.