[Interest of the combination of high-sensitivity troponine and copeptin in diagnosis of non ST elevation myocardial infarction].

Abstract:

:The diagnosis of non ST elevation myocardial infarction (NSTEMI) is very important for the emergency doctor. According to the literature copeptin, a marker of the endogenous stress, combined with troponin could be of interest in this diagnosis. The objective of the study was to investigate the association of high-sensitivity (HS) troponin and copeptine to eliminate the diagnosis of NSTEMI or unstable angina (UA) in patients arriving in Casualty with a thoracic pain. This prospective study included patients showing up at Casualty with a thoracic pain less than 12 hours old. Copeptin was measured by the BRAHMS method at admission and HS troponin was measured at admission, after 2 and 6 hours. The patients also had a follow-up phone call after 3 months. The study included 114 patients with an average age of 54.6 years. NSTEMI was diagnosed for 8.8% of them and UA for 6.1%. The patients presenting NSTEMI or UA had a copeptin rate at admission higher than the others (24.7 pmol/L versus 7.1; p < 0.002). The negative predictive value of the association of HS troponin and copeptin was 95% whereas the sensitivity was 76.5% and the specificity 78.4%. The ROC curve analysis of the copeptin results brought to light a positivity limit which would have been more successful at 10.3 pmol/L than at 14.0. The association of copeptin and HS troponin can be useful to exclude the diagnosis of NSTEMI and favours faster treatment in Casualty.

journal_name

Ann Biol Clin (Paris)

authors

Bourgeois C,Douplat M,Guieu R,Pradel V,Fromonot J,Bonnet JL,Alazia M

doi

10.1684/abc.2013.0884

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

545-54

issue

5

eissn

0003-3898

issn

1950-6112

pii

abc.2013.0884

journal_volume

71

pub_type

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