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Copeptin-marker of acute myocardial infarction.

Möckel M, Searle J - Curr Atheroscler Rep (2014)

Bottom Line: The concentration of copeptin, the C-terminal part of pro-arginine vasopressin, has been shown to increase early after acute and severe events.Owing to complementary pathophysiology and kinetics, the unspecific marker copeptin, in combination with highly cardio-specific troponin, has been evaluated as an early-rule-out strategy for acute myocardial infarction in patients presenting with signs and symptoms of acute coronary syndrome.Additionally, a recent multicenter, randomized process study, where patients who tested negative for copeptin and troponin were discharged from the emergency department, showed that the safety of the new process was comparable to that of the current standard process.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology and Division of Emergency Medicine, Campus Viorchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany, martin.moeckel@charite.de.

ABSTRACT
The concentration of copeptin, the C-terminal part of pro-arginine vasopressin, has been shown to increase early after acute and severe events. Owing to complementary pathophysiology and kinetics, the unspecific marker copeptin, in combination with highly cardio-specific troponin, has been evaluated as an early-rule-out strategy for acute myocardial infarction in patients presenting with signs and symptoms of acute coronary syndrome. Overall, most studies have reported a negative predictive value between 97 and 100 % for the diagnosis of acute myocardial infarction in low- to intermediate-risk patients with suspected acute coronary syndrome. Additionally, a recent multicenter, randomized process study, where patients who tested negative for copeptin and troponin were discharged from the emergency department, showed that the safety of the new process was comparable to that of the current standard process. Further interventional trials and data from registries are needed to ensure the effectiveness and patient benefit of the new strategy.

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Related in: MedlinePlus

Suggested new process for the workup of low- to intermediate-risk patients with suspected acute coronary syndrome (ACS) using an early rule-out strategy with combined troponin and copeptin testing
© Copyright Policy - OpenAccess
Related In: Results  -  Collection


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Fig1: Suggested new process for the workup of low- to intermediate-risk patients with suspected acute coronary syndrome (ACS) using an early rule-out strategy with combined troponin and copeptin testing

Mentions: BIC-8 has indicated that low-to intermediate-risk patients with a negative copeptin–troponin marker combination can be safely discharged. Figure 1 shows a flowchart for the suggested new process of an ACS workup. Still, clinical process studies are faced with a number of issues limiting the evaluation of a single step in a network of influencing factors and decisions. Thus, the results of this trial should be confirmed in further interventional trials. If the process is implemented in clinical practice, outcomes of patients managed with the new process strategy should be monitored closely in clinical registries to be able to judge the real-life safety and effectiveness.Fig. 1


Copeptin-marker of acute myocardial infarction.

Möckel M, Searle J - Curr Atheroscler Rep (2014)

Suggested new process for the workup of low- to intermediate-risk patients with suspected acute coronary syndrome (ACS) using an early rule-out strategy with combined troponin and copeptin testing
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4061474&req=5

Fig1: Suggested new process for the workup of low- to intermediate-risk patients with suspected acute coronary syndrome (ACS) using an early rule-out strategy with combined troponin and copeptin testing
Mentions: BIC-8 has indicated that low-to intermediate-risk patients with a negative copeptin–troponin marker combination can be safely discharged. Figure 1 shows a flowchart for the suggested new process of an ACS workup. Still, clinical process studies are faced with a number of issues limiting the evaluation of a single step in a network of influencing factors and decisions. Thus, the results of this trial should be confirmed in further interventional trials. If the process is implemented in clinical practice, outcomes of patients managed with the new process strategy should be monitored closely in clinical registries to be able to judge the real-life safety and effectiveness.Fig. 1

Bottom Line: The concentration of copeptin, the C-terminal part of pro-arginine vasopressin, has been shown to increase early after acute and severe events.Owing to complementary pathophysiology and kinetics, the unspecific marker copeptin, in combination with highly cardio-specific troponin, has been evaluated as an early-rule-out strategy for acute myocardial infarction in patients presenting with signs and symptoms of acute coronary syndrome.Additionally, a recent multicenter, randomized process study, where patients who tested negative for copeptin and troponin were discharged from the emergency department, showed that the safety of the new process was comparable to that of the current standard process.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology and Division of Emergency Medicine, Campus Viorchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany, martin.moeckel@charite.de.

ABSTRACT
The concentration of copeptin, the C-terminal part of pro-arginine vasopressin, has been shown to increase early after acute and severe events. Owing to complementary pathophysiology and kinetics, the unspecific marker copeptin, in combination with highly cardio-specific troponin, has been evaluated as an early-rule-out strategy for acute myocardial infarction in patients presenting with signs and symptoms of acute coronary syndrome. Overall, most studies have reported a negative predictive value between 97 and 100 % for the diagnosis of acute myocardial infarction in low- to intermediate-risk patients with suspected acute coronary syndrome. Additionally, a recent multicenter, randomized process study, where patients who tested negative for copeptin and troponin were discharged from the emergency department, showed that the safety of the new process was comparable to that of the current standard process. Further interventional trials and data from registries are needed to ensure the effectiveness and patient benefit of the new strategy.

Show MeSH
Related in: MedlinePlus