Abd El Baky Mahmoud Manal, Shaaban Menat Allah Ali, Ali Ramzy Ali
Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Egypt.
Department of Cardiology, Faculty of Medicine, Al Azhar University, Egypt.
Egypt Heart J. 2018 Sep;70(3):155-159. doi: 10.1016/j.ehj.2018.04.008. Epub 2018 May 10.
To assess the role of Copeptin in diagnosis of acute myocardial infarction in troponin-blind period.
This study was conducted on 40 patients who presented to emergency department complaining of chest pain and were highly suspicious to have acute cardiac ischemia, in addition to 10 subjects serving as a healthy control group. Blood samples were collected for determination of CK-MB, cTnI and Copeptin. These were measured twice (in patients' group); at 3 h and then at 6-9 h from admission time.
The first sample revealed a non-significant difference between UA group and AMI group as regards CKMB and troponin, however, high significant difference was found as regards Copeptin (Z = 5.29, P < 0.001). Moreover, ROC curve analysis of serum Copeptin for discriminating AMI group from UA group in the first sample showed diagnostic sensitivity and specificity of 100%.
Determination of copeptin in early diagnosis of AMI has diagnostic value being superior to a conventional cTn-I within the first three hours after acute chest pain.
评估 copeptin 在肌钙蛋白检测盲区诊断急性心肌梗死中的作用。
本研究纳入 40 例因胸痛就诊于急诊科且高度怀疑急性心肌缺血的患者，另外选取 10 名受试者作为健康对照组。采集血样测定肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白 I（cTnI）和 copeptin。在患者组中于入院后 3 小时及 6 - 9 小时各检测一次上述指标。
首次采样显示，不稳定型心绞痛（UA）组和急性心肌梗死（AMI）组在 CKMB 和肌钙蛋白方面无显著差异，但 copeptin 方面差异极显著（Z = 5.29，P < 0.001）。此外，首次采样时血清 copeptin 用于区分 AMI 组和 UA 组的 ROC 曲线分析显示诊断敏感性和特异性均为 100%。
在急性胸痛后的前三小时内，检测 copeptin 对 AMI 进行早期诊断具有诊断价值，优于传统的 cTn-I。
