Document Detail


Interest of the combination of high-sensitivity troponine and copeptin in diagnosis of non ST elevation myocardial infarction.
MedLine Citation:
PMID:  24113440     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Caroline Bourgeois; Marion Douplat; Régis Guieu; Vincent Pradel; Julien Fromonot; Jean-Louis Bonnet; Marc Alazia
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Annales de biologie clinique     Volume:  71     ISSN:  1950-6112     ISO Abbreviation:  Ann. Biol. Clin. (Paris)     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2984690R     Medline TA:  Ann Biol Clin (Paris)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  545-554     Citation Subset:  -    
Affiliation:
Pôle Réanimation, Urgences, Samu, CHU de la Timone, Marseille, France.
Vernacular Title:
Intérêt de l'association de la copeptine et de la troponine ultrasensible dans le diagnostic des syndromes coronariens aigus sans sus décalage du segment ST aux urgences.
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