title: [Usefulness of copeptin in discarding non-ST elevation acute myocardial infarction in patients with acute chest pain and negative first troponin I].
abstract: OBJECTIVE
  To evaluate the usefulness of copeptin as a rapid and reliable marker for discarding non-ST elevation acute myocardial infarction (NSTEMI) in patients attended in an Emergency Care Department due to acute chest pain with a normal or non-diagnostic electrocardiogram and a negative first troponin I result.
  
  
  METHODS
  A prospective observational study was carried out.
  
  
  METHODS
  The Emergency Care Department of a university hospital.
  
  
  METHODS
  The study comprised a total of 97 patients attended in the Emergency Care Department due to chest pain suggestive of acute coronary syndrome with an evolution of under 12h, a non-diagnostic electrocardiogram and a negative first troponin I result.
  
  
  METHODS
  None.
  
  
  METHODS
  Patient demographic data and baseline characteristics, copeptin upon admission, troponin I upon admission and after 6h, and final diagnosis.
  
  
  RESULTS
  The final diagnosis was NSTEMI in 14 patients (14.4%) -no significant differences in copeptin concentration being observed between the 2 groups, though a tendency towards higher values was recorded in the NSTEMI group (median: 24.6pmol/l [interquartile range: 42.0] vs. 12.0pmol/l [16.1]; P=.06). The AUC ROC for copeptin upon admission was 0.657 (95%CI: 0.504-0.810), with a negative predictive value of 92% for a cutoff point of 14pmol/l.
  
  
  CONCLUSIONS
  Copeptin determination upon admission to the Emergency Care Department in patients with chest pain for ≤12h, suggestive of acute coronary syndrome, with a non-diagnostic electrocardiogram and a negative first troponin I determination does not allow rapid and reliable exclusion of the presence of NSTEMI. Serial troponin I measurements are needed in this respect.
authors: Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, España.
authors: P
authors: P
authors: Esteban-Torrella
authors: Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, España. Electronic address: guadianarom@yahoo.es.
authors: L
authors: L
authors: García de Guadiana-Romualdo
authors: Servicio de Cardiología y Hemodinámica, Hospital Universitario Santa Lucía, Cartagena, España.
authors: L
authors: L
authors: Consuegra-Sánchez
authors: Servicio de Cardiología y Hemodinámica, Hospital Universitario Santa Lucía, Cartagena, España.
authors: D
authors: D
authors: Dau-Villarreal
authors: Servicio de Medicina Intensiva, Hospital Universitario Santa Lucía, Cartagena, España.
authors: A
authors: A
authors: Melgarejo-Moreno
authors: Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, España.
authors: M D
authors: MD
authors: Albaladejo-Otón
authors: Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Murcia, España.
authors: M
authors: M
authors: Villegas-García
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002637:Chest Pain / Q000209:etiology*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications; D000072658:Non-ST Elevated Myocardial Infarction / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D019210:Troponin I / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019210:Troponin I
keywords: Copeptin; Copeptina; Diagnosis; Diagnóstico; Infarto agudo de miocardio sin elevación del segmento ST; Non-ST elevation acute myocardial infarction; Troponin I; Troponina I