Ay M O, Erenler A K, Dogan T, Yetim M
Department of Emergency Medicine, Hitit University, Corum Training and Research Hospital, Corum, Turkey.
Eur Rev Med Pharmacol Sci. 2017 Apr;21(7):1576-1582.
The aim of this study was to investigate the effectiveness of copeptin in the early diagnosis of acute myocardial infarction (AMI), and to compare the diagnostic efficacy of copeptin with other cardiac markers.
A total of 160 cases were enrolled in the study. All were over 18 years of age, and consisted of 54 non-ST elevation MI (NSTEMI), 54 ST segment elevation MI (STEMI), and 52 healthy subjects (controls). Serum troponin-I, CK-MB mass, copeptin and CRP levels were measured in each of the cases, and were compared between the three groups for statistical differences.
The copeptin levels in the STEMI (p < 0.001) and NSTEMI (p = 0.042) groups were found to be significantly higher than the control group. Spearman's correlation analysis showed a significant positive correlation between the level of copeptin and the presence of AMI (r = 0.285, p < 0.001), CK-MB mass (r = 0.246, p = 0.002), and troponin-I (r = 0.199, p = 0.012). Sensitivity, specificity, and AUC values of the tests, according to ROC analysis performed for the diagnosis of AMI were; troponin-I > 0.1 ng/mL (71.0%, 100.0%, and 0.855); CK-MB mass > 3.59 ng/mL (77.8%, 92.3%, and 0.911); CRP > 6.37 mg/L (53.7%, 88.5%, and 0.769); and copeptin > 2.47 ng/mL (66.7%, 75.0%, and 0.676), respectively (p < 0.001).
Cardiac troponin remains the gold standard biomarker for the diagnostic evaluation of AMI. Copeptin can be used as a diagnostic marker in patients with suspected AMI in combination with other biomarkers, but, copeptin alone should not be considered as a single diagnostic marker in patients with suspected AMI.
本研究旨在探讨 copeptin 在急性心肌梗死（AMI）早期诊断中的有效性，并比较 copeptin 与其他心脏标志物的诊断效能。
本研究共纳入 160 例患者。所有患者均年龄超过 18 岁，包括 54 例非 ST 段抬高型心肌梗死（NSTEMI）患者、54 例 ST 段抬高型心肌梗死（STEMI）患者和 52 例健康受试者（对照组）。检测每例患者的血清肌钙蛋白 I、肌酸激酶同工酶质量、copeptin 和 CRP 水平，并比较三组之间的统计学差异。
发现 STEMI 组（p < 0.001）和 NSTEMI 组（p = 0.042）的 copeptin 水平显著高于对照组。Spearman 相关性分析显示，copeptin 水平与 AMI 的存在（r = 0.285，p < 0.001）、肌酸激酶同工酶质量（r = 0.246，p = 0.002）和肌钙蛋白 I（r = 0.199，p = 0.012）之间存在显著正相关。根据用于 AMI 诊断的 ROC 分析，各检测指标的敏感性、特异性和 AUC 值分别为：肌钙蛋白 I > 0.1 ng/mL（71.0%、100.0%和 0.855）；肌酸激酶同工酶质量 > 3.59 ng/mL（77.8%、92.3%和 0.911）；CRP > 6.37 mg/L（53.7%、88.5%和 0.769）；copeptin > 2.47 ng/mL（66.7%、75.0%和 0.676）（p < 0.001）。
心肌肌钙蛋白仍然是 AMI 诊断评估的金标准生物标志物。Copeptin 可与其他生物标志物联合用于疑似 AMI 患者的诊断标志物，但对于疑似 AMI 患者，不应单独将 copeptin 视为单一诊断标志物。
