title: Copeptin in acute chest pain: identification of acute coronary syndrome and obstructive coronary artery disease on coronary CT angiography.
abstract: OBJECTIVE
  To determine the diagnostic accuracy of copeptin in patients with suspected acute coronary syndrome (ACS) and its correlation with obstructive coronary artery disease (CAD) on coronary CT angiography (CTA).
  
  
  METHODS
  Copeptin was measured at arrival in 65 consecutive patients (56 ± 10 years, 45 men) suspected of ACS and no indication for immediate invasive angiography. All patients underwent coronary CTA without disclosure of the results to the treating physician, and outcomes were classified as obstructive CAD (>50% stenosis) or no obstructive CAD (≤ 50%) in one or more vessel.
  
  
  RESULTS
  The final diagnosis of ACS was established in 10 (15%) patients, 6 myocardial infarctions and 4 unstable angina pectoris. Coronary CTA detected obstructive CAD in all patients with ACS and in 10 (15%) patients with no ACS. Copeptin concentrations were higher in patients with ACS (median 7.42 pmol/l (IQR 3.71-18.72)) vs patients with no ACS (3.40 pmol/l (1.13-6.27), p=0.02). Copeptin was not higher in patients with obstructive CAD on coronary CTA (4.87 pmol/l (2.90-8.51) vs 3.60 pmol/l (1.21-6.23), p=0.20) compared with patients with no obstructive CAD.
  
  
  CONCLUSIONS
  Copeptin seems to be elevated in patients with ACS while there is no strong correlation with obstructive coronary disease on CTA.
authors.affiliation: Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Admir
authors.initials: A
authors.lastname: Dedic
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: ten Kate
authors.forename: Pleunie P M
authors.initials: PP
authors.lastname: Rood
authors.forename: Tjebbe W
authors.initials: TW
authors.lastname: Galema
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ouhlous
authors.forename: Adriaan
authors.initials: A
authors.lastname: Moelker
authors.forename: Pim J
authors.initials: PJ
authors.lastname: de Feyter
authors.forename: Yolanda B
authors.initials: YB
authors.lastname: de Rijke
authors.forename: Koen
authors.initials: K
authors.lastname: Nieman
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis*; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000097:blood / Q000175:diagnosis*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins
keywords: acute coronary syndrome; cardiac care, diagnosis; emergency departments; imaging, CT/MRI