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

Waldsperger, Hanna; Biener, Moritz; Stoyanov, Kiril M; Vafaie, Mehrshad; Katus, Hugo A.; Giannitsis, Evangelos; Mueller‐Hennessen, Matthias

doi:10.3390/jcm9113627

Cited by 10 publications

(13 citation statements)

References 25 publications

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“…However, we should also consider that the C-statistics of 0.718 for the combination of increased hs-cTnI and copeptin is rather modest and hence has to be interpreted within the context of the individual clinical situation. This observation in patients with confirmed COVID-19 is very consistent with findings in 3890 patients presenting with acute symptoms to the emergency department [ 24 ]. In a multivariate Cox regression model, elevated copeptin was independently associated with all-cause death in the acute coronary syndrome (HR = 1.7 (95% CI 1.3–2.3), p = 0.002) and non—acute coronary syndrome cohort (HR = 2.7 (95% CI 1.4–5.0), p = 0.0018).…”

Section: Discussionsupporting

confidence: 89%

Improvement of outcome prediction of hospitalized patients with COVID-19 by a dual marker strategy using high-sensitive cardiac troponin I and copeptin

et al. 2021

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Section: Discussionsupporting

confidence: 89%

Improvement of outcome prediction of hospitalized patients with COVID-19 by a dual marker strategy using high-sensitive cardiac troponin I and copeptin

et al. 2021

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“…A risk stratification, an important issue in this context, 37,38 yielded the following results. Levels above 100 ng/L of cTnT indicate high risk with very high mortality rates.…”

Section: Discussionmentioning

confidence: 97%

Prehospital troponin as a predictor of early clinical deterioration

Martin-Rodríguez

Sanz-García

Castro-Portillo

et al. 2021

Eur J Clin Investigation

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Background and Objectives Elevated troponin T (cTnT) values are associated with comorbidities and early mortality, in both cardiovascular and noncardiovascular diseases. The objective of this study is to evaluate the prognostic accuracy of the sole utilization of prehospital point‐of‐care cardiac troponin T to identify the risk of early in‐hospital deterioration, including mortality within 28 days. Methods We conducted a prospective, multicentric, controlled, ambulance‐based, observational study in adults with acute diseases transferred with high priority by ambulance to emergency departments, between 1 January and 30 September 2020. Patients with hospital diagnosis of acute coronary syndrome were excluded. The discriminative power of the predictive cTnT was assessed through a discrimination model trained using a derivation cohort and evaluated by the area under the curve of the receiver operating characteristic on a validation cohort. Results A total of 848 patients were included in our study. The median age was 68 years (25th‐75th percentiles: 50‐81 years), and 385 (45.4%) were women. The mortality rate within 28 days was 12.4% (156 cases). The predictive ability of cTnT to predict mortality presented an area under the curve of 0.903 (95% CI: 0.85‐0.954; P < .001). Risk stratification was performed, resulting in three categories with the following optimal cTnT cut‐off points: high risk greater than or equal to 100, intermediate risk 40‐100 and low risk less than 40 ng/L. In the high‐risk group, the mortality rate was 61.7%, and on the contrary, the low‐risk group presented a mortality of 2.3%. Conclusions The implementation of a routine determination of cTnT on the ambulance in patients transferred with high priority to the emergency department can help to stratify the risk of these patients and to detect unknown early clinical deterioration.

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“…However, the role of copeptin in the prognosis is less validated and has not been recommended. Several studies have indicated that copeptin is a useful prognostic predictor for adverse outcomes in patients with ACS (83,(161)(162)(163)(164), and the predictive performance for 180-day mortality was significantly better in combination with copeptin and cTnI than with cTnI alone (75). However, some controversial results have argued that there is no significant predictive ability of copeptin (alone or with cTn) for ACS outcomes (108,165,166).…”

Section: Copeptin To Predicting Mortality and Adverse Outcome In Amimentioning

confidence: 99%

Copeptin as a Diagnostic and Prognostic Biomarker in Cardiovascular Diseases

Cheng

Qiu

et al. 2022

Front. Cardiovasc. Med.

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Copeptin is the carboxyl-terminus of the arginine vasopressin (AVP) precursor peptide. The main physiological functions of AVP are fluid and osmotic balance, cardiovascular homeostasis, and regulation of endocrine stress response. Copeptin, which is released in an equimolar mode with AVP from the neurohypophysis, has emerged as a stable and simple-to-measure surrogate marker of AVP and has displayed enormous potential in clinical practice. Cardiovascular disease (CVD) is currently recognized as a primary threat to the health of the population worldwide, and thus, rapid and effective approaches to identify individuals that are at high risk of, or have already developed CVD are required. Copeptin is a diagnostic and prognostic biomarker in CVD, including the rapid rule-out of acute myocardial infarction (AMI), mortality prediction in heart failure (HF), and stroke. This review summarizes and discusses the value of copeptin in the diagnosis, discrimination, and prognosis of CVD (AMI, HF, and stroke), as well as the caveats and prospects for the application of this potential biomarker.

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

Cited by 10 publications

References 25 publications

Improvement of outcome prediction of hospitalized patients with COVID-19 by a dual marker strategy using high-sensitive cardiac troponin I and copeptin

Improvement of outcome prediction of hospitalized patients with COVID-19 by a dual marker strategy using high-sensitive cardiac troponin I and copeptin

Prehospital troponin as a predictor of early clinical deterioration

Copeptin as a Diagnostic and Prognostic Biomarker in Cardiovascular Diseases

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