Comparison of the temporal release pattern of copeptin with conventional biomarkers in acute myocardial infarction

Abstract

BackgroundEarly detection of acute myocardial infarction (AMI) using cardiac biomarkers of myocardial necrosis remains limited since these biomarkers do not rise within the first hours from onset of AMI. We aimed to compare the temporal release pattern of the C-terminal portion of provasopressin (copeptin) with conventional cardiac biomarkers, including creatine kinase isoenzyme (CK-MB), cardiac troponin T (cTnT), and high-sensitivity cTnT (hs-cTnT), in patients with ST-elevation AMI.MethodsWe included 145 patients undergoing successful primary percutaneous coronary intervention (PCI) for a first ST-elevation AMI presenting within 12 h of symptom onset. Blood samples were taken on admission and at four time points within the first 24 h after PCI.ResultsIn contrast to all other markers, copeptin levels were already elevated on admission and were higher with a shorter time from symptom onset to reperfusion and lower systolic blood pressure. Copeptin levels peaked immediately after symptom onset at a maximum of 249 pmol/L and normalized within 10 h. In contrast, CK-MB, cTnT, and hs-cTnT peaked after 14 h from symptom onset at a maximum of 275 U/L, 5.75 μg/L, and 4.16 μg/L, respectively, and decreased more gradually.ConclusionsCopeptin has a distinct release pattern in patients with ST-elevation AMI, peaking within the first hour after symptom onset before conventional cardiac biomarkers and falling to normal ranges within the first day. Further studies are required to determine the exact role of copeptin in AMI suspects presenting within the first hours after symptom onset.

Recent Advances in Biomarker Discovery — from Serum to Imaging-based Biomarkers for a Complex Assessment of Heart Failure Patients

“…42 The association of hs-cTnT with copeptin in a common biomarker panel slightly increased the rate of ACS detection at admission. 43 A more recent study of copeptin on 195 patients with a 5-year follow-up demonstrated that copectin is an independent long-term prognostic indicator in HfrEF patients.…”

Evaluation of a Sensitive Copeptin Assay for Clinical Measurement

“…The most direct application for copeptin measurement is in the diagnosis of central diabetes insipidus, a disease caused by a primary vasopressin synthesis defect [4]. Measurement of copeptin has also been suggested in the early exclusion of acute myocardial infarction among patients with suspected acute coronary syndrome [5,6,10]. In addition, copeptin measurement provides prognostic information in several acute conditions such as myocardial infarction [11], heart failure [12][13][14][15][16], infection [17][18][19], stroke [20,21], traumatic…”

Significance of Copeptin in Diagnostics of Myocardial Infarction

“…Так, в исследовании Gu YL, et al (2011) [15] у 145 больных ИМ с подъемом сегмента ST на ЭКГ определяли в динамике уровни в крови копептина, КК-МВ и Tn Т. Обнаружено, что пик содержания копептина регистрировался немедленно после развития симптомов ИМ и составлял 249 пмоль/л. Пиковые значения КК-МВ и Tn Т регистри-ровались гораздо позже и составляли 275 ед./л и 5,75 мкг/л, соответственно.…”

“…Механизм повышения копептина в крови при ИМ, по мнению Gu YL, et al (2011) [15], обусловлен снижением сердечного выброса, изменениями гемо-динамики и/или АД. Самостоятельное значение Аналогичные данные получены в крупном много-центровом исследовании COPED-MIRRO (2014) [21].…”