Your browser doesn't support javascript.
loading
Copeptin for the differentiation of type 1 versus type 2 myocardial infarction or myocardial injury.
Kassem, Mona; Ayala, Pedro Lopez; Andric-Cancarevic, Tijana; Tajsic, Milos; Vargas, Kris G; Bendik, Dimitri; Kaufmann, Christoph; Wojta, Johann; Mueller, Christian; Huber, Kurt.
Afiliación
  • Kassem M; 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria. Electronic address: mona.ah.kassem@gmail.com.
  • Ayala PL; Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.
  • Andric-Cancarevic T; 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.
  • Tajsic M; 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.
  • Vargas KG; 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
  • Bendik D; Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.
  • Kaufmann C; 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.
  • Wojta J; Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria.
  • Mueller C; Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.
  • Huber K; 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria; Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria; Sigmund Freud University, Medical School, Vienna, Austria.
Int J Cardiol ; 403: 131879, 2024 May 15.
Article en En | MEDLINE | ID: mdl-38369132
ABSTRACT

BACKGROUND:

The rapid and reliable differentiation of myocardial infarction (MI) due to atherothrombosis (T1MI) from MI due to supply-demand mismatch (T2MI) or acute myocardial injury is of major clinical relevance due to very different treatments, but still a major unmet clinical need. This study aimed to investigate whether copeptin, a stress hormone produced in the hypothalamus, helps to differentiate between T1MI versus T2MI or injury.

METHODS:

In a retrospective analysis, 1271 unselected consecutive patients presenting with symptoms suggestive of MI to the emergency department were evaluated. Patients diagnosed with ST-elevation MI were excluded. All patients with elevated cardiac troponin I (cTnI) concentration possibly indicating MI were classified into T1MI, T2MI, or acute myocardial injury using detailed clinical assessment and coronary imaging. Copeptin plasma concentration was measured in a blinded fashion. A multicenter diagnostic study with central adjudication of the final diagnosis served as external validation cohort (n = 1390).

RESULTS:

Among 1161 patients, 154 patients had increased cTnI concentration. Of these, 78 patients (51%) were classified as T1MI and 76 (49%) as T2MI or myocardial injury. Patients with T2MI or myocardial injury had significantly higher copeptin plasma concentration between patients versus T1MI (21,4 pmol/l versus 8,1 pmol/l, p = 0,001). A multivariable regression analysis revealed that higher concentrations of copeptin and C-reactive protein, higher heart rate at presentation and lower frequency of smoking remained significantly associated with T2MI and myocardial injury. Findings were largely confirmed in the external validation cohort.

CONCLUSION:

In patients without ST-segment elevation, copeptin concentration was higher in T2MI and myocardial Injury versus T1MI and may help in their differential diagnosis.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Glicopéptidos / Infarto de la Pared Anterior del Miocardio / Lesiones Cardíacas / Infarto del Miocardio Límite: Humans Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Glicopéptidos / Infarto de la Pared Anterior del Miocardio / Lesiones Cardíacas / Infarto del Miocardio Límite: Humans Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos