Document Detail


The utility of copeptin in the emergency department as a predictor of adverse outcomes in non-ST-elevation acute coronary syndrome: the COPED-PAO study.
MedLine Citation:
PMID:  23371977     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: To test the utility of a single copeptin determination at presentation to the emergency department (ED) as a short-term prognosis marker in patients with non-ST-elevation acute coronary syndrome (NSTEACS). To compare the results with those achieved with conventional troponin. METHODS: A multicentric, prospective, observational, longitudinal, cohort study involving 15 Spanish EDs. Inclusion: consecutive patients with chest pain (<12 h) finally diagnosed of NSTEACS. Measurements: copeptin and troponin at arrival. Cut-off point for copeptin: 25.9 pmol/l. Follow-up: within 2 months after ED attendance to identify 30-day adverse events. Discriminatory capacity of copeptin and troponin was compared by receiver operating characteristic (ROC) curves. RESULTS: We included 377 patients with NSTEACS. Adverse events: 11 (2.9%) patients died, 27 (7.2%) had an adverse coronary event, 14 (3.7%) had a stroke, and 48 (12.7%) a composite endpoint. The initial copeptine value was over 25.9 pmol/l in 114 patients, and they presented a higher mortality rate (OR: 4.2, (95% CI 1.2 to 14.8); p=0.03). This association disappeared after adjusting by clinical variables or troponin level. No significant differences were found for the remaining endpoints. The area under the curve  of the ROC curve of 30-day mortality was 0.73 (95% CI 0.58 to 0.87) for copeptin, and 0.80 (95% CI 0.73 to 0.87) for troponin. CONCLUSIONS: In patients with NSTEACS, determination of copeptin at presentation to the ED is associated with risk of death during the subsequent month. This association, however, disappears after adjusting by baseline features or troponin level, so copeptin does not add complementary prognostic information over that provided by troponin.
Authors:
Miquel Sánchez; Pere Llorens; Pablo Herrero; F Javier Martín-Sanchez; Pascual Piñera; Oscar Miró;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-31
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  -     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-2-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Emergency Department, Àrea d'Urgències, Hospital Clínic de Barcelona, Grupo de Investigación 'Urgencias: procesos y patologias', IDIBAPS, Barcelona, Catalonia, Spain.
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Investigator
Investigator/Affiliation:
Ana Bella Alvarez-Medina / ; Jose M Pavón Monzo / ; M José Pérez Durá / ; José Manuel Vallés Tarazona / ; Pedro García / ; Sara Esteve Poblador / ; Daniela Rosillo Castro / ; Esther Tomás Jiménez / ; Yolanda Jarabo López / ; Yolanda Morales / ; Juan González Del Castillo / ; Pedro Ruiz Artacho / ; José Ramón Casal Codesido / ; M Jesús Corullón Fernández / ; Sebastián Martínez Fernández / ; José Lázaro González / ; Cristina Gil Castillo / ; Marta Fuentes de Frutos / ; José Juan Gil Román / ; Rocío Marino Genicio / ; Luis García-Castrillo Riesgo / ; Héctor Alonso Valle / ; Beatriz López Barbeito / ; Xavier Alemany González / ; Ferrán Llopis Roca / ; Dr Javier Jacob Rodríguez / ; Emili Gené Tous / ; Mónica Mariñosa Marré / ; M Carme Boqué Oliva / ; Nuria Alba Molina / ; Francisco José Ezponda Inchauspe / ; Ana Alonso de Miguel / ; Javier Povar Marco / ; José Miguel Franco Sorolla / ; Gonzalo López Vaquera / ; Elena Baztarrica Echarte / ; Juan Sánchez López / ; M José Moral Cabrera / ; Patricia Godoy Rodríguez / ; Francisco Temboury / ; José Manuel Garrido Castilla / ; Carmen Navarro Bustos / ; Francisco Ruiz Romero / ; Angel Alvarez Márquez / ; Luis Jiménez Murillo / ; Julio Aparicio Sánchez / ; Francisco Manuel Parrilla Ruiz / ; Dolores Cárdenas Cruz / ; Manuel J Vázquez Lima / ; Celestino Sieira Ferrin / ; Jesús Santos Velasco / ; Pedro Hernández Arenillas / ; Bernardo Oliveras / ; José Carbajosa-Dalmau / ; Enrique Villena / ; Cesar Gonzalez /

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