Can copeptin and troponin T ratio predict final infarct size and myocardial salvage index in patients with ST-elevation myocardial infarction: A sub-study of the DANAMI-3 trial.
Clin Biochem
; 59: 37-42, 2018 Sep.
Article
em En
| MEDLINE
| ID: mdl-29932892
ABSTRACT
BACKGROUND:
Primary percutaneous coronary intervention (pPCI) is recommended in patients presenting with ST-elevation myocardial infarction (STEMI) within <12â¯h of symptom onset. However, patients-reported symptom duration is not always reliable. Cardiac specific troponin T (cTnT) and the endogenous stress marker copeptin have different temporal release patterns for myocardial infarction MI. We hypothesized that copeptin/troponin-ratio is associated to the duration of coronary occlusion and therefore inversely proportional to myocardial salvage.METHOD:
Patients older than 18â¯years with first time STEMI referred to pPCI were eligible. cTnT and copeptin values were measured at admission. A cardiac magnetic resonance scanning (CMR) was done during the index admission for assessment of area at risk (AAR), and later 3â¯months to assess final infarct size (FIS). Myocardial salvage index (MSI) was calculated based on these measurements.RESULTS:
A total of 468 patients were included. The median time from patient-reported onset of symptoms to pPCI was 192â¯min (IQR 150â¯min - 290â¯min). At presentation 416 (89%) patients had hs-cTnT values above the 99th percentile, median hs-cTnT was 53â¯ng/l (IQR 24â¯ng/l-146â¯ng/l) and 318 (68%) patients had copeptin values above the 99th percentile (18.9â¯pmol/l), median copeptin was 50â¯pmol/l (IQR 14â¯pmol/l-131â¯pmol/l). Symptom duration showed a weak but significant association with AAR (R2â¯=â¯0.02, pâ¯=â¯.04), FIS (R2â¯=â¯0.03, pâ¯<â¯.01) and MSI (R2â¯=â¯0.04, pâ¯<â¯.01). Copeptin/troponin-ratio was significantly associated with symptom duration (R2â¯=â¯0.19, pâ¯<â¯.01), but not AAR (R2â¯=â¯0.02, pâ¯=â¯.19), FIS (R2â¯=â¯0.02, pâ¯=â¯.12), or MSI (R2â¯=â¯0.01, pâ¯=â¯.25).CONCLUSION:
Copeptin/troponin-ratio is associated with patient-reported symptom duration, but there was no association with area at risk, final infarct size or myocardial salvage index.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Glicopeptídeos
/
Troponina T
/
Infarto do Miocárdio com Supradesnível do Segmento ST
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article