title: Comparison of the temporal release pattern of copeptin with conventional biomarkers in acute myocardial infarction.
abstract: BACKGROUND
  Early detection of acute myocardial infarction (AMI) using cardiac biomarkers of myocardial necrosis remains limited since these biomarkers do not rise within the first hours from onset of AMI. We aimed to compare the temporal release pattern of the C-terminal portion of provasopressin (copeptin) with conventional cardiac biomarkers, including creatine kinase isoenzyme (CK-MB), cardiac troponin T (cTnT), and high-sensitivity cTnT (hs-cTnT), in patients with ST-elevation AMI.
  
  
  METHODS
  We included 145 patients undergoing successful primary percutaneous coronary intervention (PCI) for a first ST-elevation AMI presenting within 12 h of symptom onset. Blood samples were taken on admission and at four time points within the first 24 h after PCI.
  
  
  RESULTS
  In contrast to all other markers, copeptin levels were already elevated on admission and were higher with a shorter time from symptom onset to reperfusion and lower systolic blood pressure. Copeptin levels peaked immediately after symptom onset at a maximum of 249 pmol/L and normalized within 10 h. In contrast, CK-MB, cTnT, and hs-cTnT peaked after 14 h from symptom onset at a maximum of 275 U/L, 5.75 μg/L, and 4.16 μg/L, respectively, and decreased more gradually.
  
  
  CONCLUSIONS
  Copeptin has a distinct release pattern in patients with ST-elevation AMI, peaking within the first hour after symptom onset before conventional cardiac biomarkers and falling to normal ranges within the first day. Further studies are required to determine the exact role of copeptin in AMI suspects presenting within the first hours after symptom onset.
authors.affiliation: Department of Cardiology, Thorax Center, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30001, 9700 RB, Groningen, The Netherlands.
authors.forename: Youlan L
authors.initials: YL
authors.lastname: Gu
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Voors
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hillege
authors.forename: Joachim
authors.initials: J
authors.lastname: Struck
authors.forename: Serge
authors.initials: S
authors.lastname: Masson
authors.forename: Tarcisio
authors.initials: T
authors.lastname: Vago
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.forename: Ad F M
authors.initials: AF
authors.lastname: van den Heuvel
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
authors.forename: Bart J G L
authors.initials: BJ
authors.lastname: de Smet
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D009426:Netherlands; D011237:Predictive Value of Tests; D013997:Time Factors; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; D020107:Troponin T; C048197:copeptins; D052279:Creatine Kinase, MB Form