Does plasma copeptin level at admission predict final infarct size in ST-elevation myocardial infarction

Ananth, Vijai; Beig, Jahangir Rashid; Tramboo, Nisar A.; Rasool, Roohi; Choh, Nasir A; Bashir, Shazia; Rather, Hilal; Lone, Ajaz Ahmad

doi:10.1016/j.ijcard.2016.06.025

Cited by 15 publications

(12 citation statements)

References 28 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, concerning the ability to predict final infarct size determined by cardiac MRI, diverging results in AMI patients have been reported. While Ananth et al showed that copeptin levels at admission independently predicted final infarct size [23], a sub-study of the DANAMI-3 trial found that there was no association of the copeptin/troponin ratio with the final infarct size [24].…”

Section: Discussionmentioning

confidence: 98%

Prognostic Value of Elevated Copeptin and High-Sensitivity Cardiac Troponin T in Patients with and without Acute Coronary Syndrome: The ConTrACS Study

Waldsperger

Biener

Stoyanov

et al. 2020

JCM

View full text Add to dashboard Cite

Aims: We aimed to assess the prognostic role of copeptin in patients presenting to the emergency department with acute symptoms and increased high-sensitivity cardiac troponin T. Methods: A total of 3890 patients presenting with acute symptoms to the emergency department of Heidelberg University Hospital were assessed for increased hs-cTnT (>14 ng/L) from three cohorts: the Heidelberg Acute Coronary Syndrome (ACS) Registry (n = 2477), the BIOPS Registry (n = 320), and the ACS OMICS Registry (n = 1093). In a pooled analysis, 1956 patients remained, comprising of 1600 patients with ACS and 356 patients with non-ACS. Results: Median follow-up was 1468 days in the ACS cohort and 709 days in the non-ACS cohort. Elevated copeptin levels (>10 pmol/L) were found in 1174 patients (60.0%) in the entire cohort (58.1% in ACS and 68.5% in non-ACS, respectively) and mortality rates were significantly higher than in patients with normal copeptin levels (29.0% vs. 10.7%, p < 0.001). In a multivariate Cox regression, elevated copeptin was independently associated with all-cause death in the ACS (HR = 1.7, 1.3–2.3, p = 0.002) and non-ACS cohort (HR = 2.7, 1.4–5.0, p = 0.0018). Conclusion: Copeptin may aid in identifying patients at risk for adverse outcomes in patients with increased levels of hs-cTnT in ACS patients and in non-ACS conditions.

show abstract

Section: Discussionmentioning

confidence: 98%

Prognostic Value of Elevated Copeptin and High-Sensitivity Cardiac Troponin T in Patients with and without Acute Coronary Syndrome: The ConTrACS Study

Waldsperger

Biener

Stoyanov

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…This leads to speculate, first, that this is the reason why hs-TnT measured at admission had low prognostic value and, second, that copeptin might be considered an early indirect predictor of infarct size. The latter hypothesis was recently evaluated and confirmed in a population of STEMI patients [ 19 ]. As a consequence might be regarded the observation of predictive value of copeptin for the development of heart failure, with higher and diagnostic for HF levels of NT-proBNP among patients stratified with copeptin, age, and GFR as high risk.…”

Section: Discussionmentioning

confidence: 90%

Copeptin as a Prognostic Marker in Acute Chest Pain and Suspected Acute Coronary Syndrome

et al. 2018

View full text Add to dashboard Cite

Background In patients admitted with chest pain and suspected acute coronary syndrome (ACS), it is crucial to early identify those who are at higher risk of adverse events. The study aim was to assess the predictive value of copeptin in patients admitted to the emergency department with chest pain and nonconclusive ECG. Methods Consecutive patients suspected for an ACS were enrolled prospectively. Copeptin and high-sensitive troponin T (hs-TnT) were measured at admission. Patients were followed up at six and 12 months for the occurrence of death and major adverse cardiac and cerebrovascular events (MACCE). Results Among 154 patients, 11 patients died and 26 experienced MACCE. Mortality was higher in copeptin-positive than copeptin-negative patients with no difference in the rate of MACCE. Copeptin reached the AUC 0.86 (0.75–0.97) for prognosis of mortality at six and 0.77 (0.65–0.88) at 12 months. It was higher than for hs-TnT and their combination at both time points. Copeptin was a strong predictor of mortality in the Cox analysis (HR14.1 at six and HR4.3 at 12 months). Conclusions Copeptin appears to be an independent predictor of long-term mortality in a selected population of patients suspected for an ACS. The study registration number is ISRCTN14112941.

show abstract

“…56 Due to the distinct temporal pattern of copeptin release, it provides a diagnostic aid especially in the first 3 hours of symptom onset, when cardiac troponin levels have not yet increased. 56,57,59 In an experimental study on pigs, increased circulating copeptin levels were related to changes in mean arterial pressure, that is, animals with high values showed a reduction in mean arterial pressure as a consequence of MI. 60 In the post -MI period (days 2-5), copeptin levels were found to be associated with myocardial remodeling and heart failure in survivors of MI.…”

Section: Cardiac Synthesis Of Arginine Vasopressinmentioning

confidence: 99%

“…Furthermore, copeptin levels on admission were found to independently predict the final infarct size in a multivariate analysis. 59 Copeptin levels were also assessed in other populations, including 1195 stable ambulatory patients with type 2 diabetes. 62 In a 10-year follow -up, copeptin levels were associated with cardiovascular death (hazard ratio, 1.17; 95% CI, 0.99-1.39; P = 0.068) and all -cause mortality (hazard ratio, 1.22; 95% CI, 1.09-1.36; P = 0.001).…”

mentioning

confidence: 99%

The role of arginine vasopressin in myocardial infarction and reperfusion

2019

View full text Add to dashboard Cite

Little attention is paid to the coronary microvasculature when treating acute myocardial infarction (MI). Microvascular obstruction (MVO) contributes to ischemia-reperfusion injury, which hampers distal blood flow to the myocardium despite recanalization of the culprit epicardial vessel. One of the mechanisms behind reperfusion injury is MVO due to persistent vasoconstrictor tone during reperfusion. Arginine vasopressin (AVP) is a hormone with prominent vasoactive effects on the coronary microvessels. Its levels are elevated as part of a stress response triggered by MI, which was shown to exert vasoconstrictive effects on the coronary arteries in preclinical models, mainly in the nonepicardial vessels of the microcirculation. Circulating AVP levels are up to 100-fold higher in MI and do not immediately decrease to baseline levels on reperfusion. This results in the so called coronary slow flow phenomenon and mediates ischemia-reperfusion injury. Recently, the C-terminal fragment of preprovasopressin, copeptin, has emerged as a surrogate biomarker for AVP, as it is more stable in the circulation. Multiple studies have shown the predictive value of both AVP and copeptin with regards to long-term prognoses of MI patients. We propose that both AVP and copeptin have more than just a predictive value but also play a role in the pathophysiology of adverse outcome post-MI. Therefore, the treatment of choice for MI should not only focus on the epicardial vessel but also on targeting MVO that might pre-exist or might directly follow reperfusion. This mandates a clinical trial with an AVP-receptor antagonist in patients with acute MI undergoing reperfusion therapy.

show abstract

Does plasma copeptin level at admission predict final infarct size in ST-elevation myocardial infarction

Cited by 15 publications

References 28 publications

Prognostic Value of Elevated Copeptin and High-Sensitivity Cardiac Troponin T in Patients with and without Acute Coronary Syndrome: The ConTrACS Study

Prognostic Value of Elevated Copeptin and High-Sensitivity Cardiac Troponin T in Patients with and without Acute Coronary Syndrome: The ConTrACS Study

Copeptin as a Prognostic Marker in Acute Chest Pain and Suspected Acute Coronary Syndrome

The role of arginine vasopressin in myocardial infarction and reperfusion

Contact Info

Product

Resources

About