Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Emerg Med J. 2013 Nov;30(11):910-3. doi: 10.1136/emermed-2012-201596. Epub 2012 Nov 8.
To determine the diagnostic accuracy of copeptin in patients with suspected acute coronary syndrome (ACS) and its correlation with obstructive coronary artery disease (CAD) on coronary CT angiography (CTA).
Copeptin was measured at arrival in 65 consecutive patients (56 ± 10 years, 45 men) suspected of ACS and no indication for immediate invasive angiography. All patients underwent coronary CTA without disclosure of the results to the treating physician, and outcomes were classified as obstructive CAD (>50% stenosis) or no obstructive CAD (≤ 50%) in one or more vessel.
The final diagnosis of ACS was established in 10 (15%) patients, 6 myocardial infarctions and 4 unstable angina pectoris. Coronary CTA detected obstructive CAD in all patients with ACS and in 10 (15%) patients with no ACS. Copeptin concentrations were higher in patients with ACS (median 7.42 pmol/l (IQR 3.71-18.72)) vs patients with no ACS (3.40 pmol/l (1.13-6.27), p=0.02). Copeptin was not higher in patients with obstructive CAD on coronary CTA (4.87 pmol/l (2.90-8.51) vs 3.60 pmol/l (1.21-6.23), p=0.20) compared with patients with no obstructive CAD.
Copeptin seems to be elevated in patients with ACS while there is no strong correlation with obstructive coronary disease on CTA.
确定 copeptin 在疑似急性冠状动脉综合征（ACS）患者中的诊断准确性及其与冠状动脉 CT 血管造影（CTA）中阻塞性冠状动脉疾病（CAD）的相关性。
在 65 名连续疑似 ACS 且无立即进行有创血管造影指征的患者（56±10 岁，45 名男性）入院时测量 copeptin。所有患者均接受冠状动脉 CTA 检查，但不向主治医生透露检查结果，根据结果将患者分为存在阻塞性 CAD（>50%狭窄）或无阻塞性 CAD（≤50%狭窄）。
ACS 的最终诊断在 10 名（15%）患者中确立，其中 6 名患有心肌梗死，4 名患有不稳定型心绞痛。冠状动脉 CTA 在所有 ACS 患者和 10 名（15%）无 ACS 患者中均发现了阻塞性 CAD。ACS 患者的 copeptin 浓度较高（中位数 7.42 pmol/l（IQR 3.71-18.72）），而无 ACS 的患者的 copeptin 浓度较低（3.40 pmol/l（1.13-6.27），p=0.02）。与无阻塞性 CAD 的患者相比，冠状动脉 CTA 上存在阻塞性 CAD 的患者 copeptin 浓度并没有更高（4.87 pmol/l（2.90-8.51）比 3.60 pmol/l（1.21-6.23），p=0.20）。
copeptin 在 ACS 患者中似乎升高，而与 CTA 上的阻塞性冠状动脉疾病无明显相关性。
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