Department of Cardiology, Faculty of Medicine, Cukurova University.
Department of Cardiology, Osmancik State Hospital.
Int Heart J. 2021 May 29;62(3):528-533. doi: 10.1536/ihj.20-683. Epub 2021 May 1.
This study aimed to identify the serum copeptin levels in patients diagnosed with unstable angina (UA) and evaluate the relationship between the patients' copeptin levels and angiographic severity.A total of 200 patients who were diagnosed with UA and underwent coronary angiography were included in the study. Clinical, electrocardiographic, echocardiographic, and laboratory data (high-sensitivity cardiac troponin T and copeptin levels) as well as The Global Registry of Acute Coronary Events (GRACE) 1.0 risk score were recorded upon admission. Moreover, the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score was calculated following coronary angiography.We isolated and defined two subgroups within our study population: group 1 included patients with non-significant coronary artery disease (CAD) (< 50% diameter stenosis, n = 105); group 2 included patients with significant CAD (≥ 50% diameter stenosis, n = 95). The number of cases with a GRACE score higher than 140 was significantly higher in group 2 than in group 1 (P < 0.001). The SYNTAX scores and copeptin levels were significantly higher in group 2 than in group 1 (P < 0.001 for both). A positive correlation was observed between the copeptin levels and SYNTAX scores (r = 0.683; P < 0.001), and the cut-off level of copeptin was 18.3 pmol/L (sensitivity of 74.7%, specificity of 83.8%, and area under the curve of 0.795).This study suggests that it may be beneficial to use conventional scoring systems and serum copeptin levels when identifying high-risk UA patients.
本研究旨在确定不稳定型心绞痛（UA）患者的血清copeptin 水平，并评估患者 copeptin 水平与血管造影严重程度之间的关系。共纳入 200 例经冠状动脉造影诊断为 UA 的患者。入院时记录临床、心电图、超声心动图和实验室数据（高敏心肌肌钙蛋白 T 和 copeptin 水平）以及全球急性冠状动脉事件注册（GRACE）1.0 风险评分。此外，还计算了冠状动脉造影后的 SYNTAX 评分。我们在研究人群中分离并定义了两个亚组：第 1 组包括非显著性冠状动脉疾病（CAD）患者（<50% 直径狭窄，n=105）；第 2 组包括显著性 CAD 患者（≥50% 直径狭窄，n=95）。第 2 组 GRACE 评分>140 的病例数明显高于第 1 组（P<0.001）。第 2 组的 SYNTAX 评分和 copeptin 水平明显高于第 1 组（均 P<0.001）。Copeptin 水平与 SYNTAX 评分呈正相关（r=0.683；P<0.001），Copeptin 的截断值为 18.3 pmol/L（灵敏度为 74.7%，特异性为 83.8%，曲线下面积为 0.795）。本研究表明，在识别高危 UA 患者时，使用常规评分系统和血清 copeptin 水平可能有益。
