copeptin 作为急性胸痛和疑似急性冠状动脉综合征的预后标志物。
Copeptin as a Prognostic Marker in Acute Chest Pain and Suspected Acute Coronary Syndrome.
机构信息
2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, M. Skłodowskiej-Curie 10, 41-800 Zabrze, Poland.
Department of Cardiology, Tuen Mun Hospital, 23 Tsing Chung Koon Rd, Tuen Mun, Hong Kong.
出版信息
Dis Markers. 2018 Jan 24;2018:6597387. doi: 10.1155/2018/6597387. eCollection 2018.
BACKGROUND
In patients admitted with chest pain and suspected acute coronary syndrome (ACS), it is crucial to early identify those who are at higher risk of adverse events. The study aim was to assess the predictive value of copeptin in patients admitted to the emergency department with chest pain and nonconclusive ECG.
METHODS
Consecutive patients suspected for an ACS were enrolled prospectively. Copeptin and high-sensitive troponin T (hs-TnT) were measured at admission. Patients were followed up at six and 12 months for the occurrence of death and major adverse cardiac and cerebrovascular events (MACCE).
RESULTS
Among 154 patients, 11 patients died and 26 experienced MACCE. Mortality was higher in copeptin-positive than copeptin-negative patients with no difference in the rate of MACCE. Copeptin reached the AUC 0.86 (0.75-0.97) for prognosis of mortality at six and 0.77 (0.65-0.88) at 12 months. It was higher than for hs-TnT and their combination at both time points. Copeptin was a strong predictor of mortality in the Cox analysis (HR14.1 at six and HR4.3 at 12 months).
CONCLUSIONS
Copeptin appears to be an independent predictor of long-term mortality in a selected population of patients suspected for an ACS. The study registration number is ISRCTN14112941.
背景
对于因胸痛而住院且疑似急性冠脉综合征（ACS）的患者，早期识别出那些具有更高不良事件风险的患者至关重要。本研究旨在评估入院时胸痛且心电图非特异性的患者中 copeptin 的预测价值。
方法
连续入选疑似 ACS 的患者。入院时测量 copeptin 和高敏肌钙蛋白 T（hs-TnT）。对患者进行 6 个月和 12 个月的随访，以记录死亡和主要不良心脏和脑血管事件（MACCE）的发生情况。
结果
在 154 例患者中，有 11 例死亡，26 例发生 MACCE。与 copeptin 阴性患者相比，copeptin 阳性患者的死亡率更高，但 MACCE 发生率无差异。在 6 个月和 12 个月时，copeptin 对死亡率的 AUC 分别为 0.86（0.75-0.97）和 0.77（0.65-0.88），高于 hs-TnT 及其组合。在 Cox 分析中，copeptin 是死亡率的强预测因子（6 个月时 HR 为 14.1，12 个月时 HR 为 4.3）。
结论
在疑似 ACS 的患者中，copeptin 似乎是长期死亡率的独立预测因子。本研究的注册号为 ISRCTN14112941。
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