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Acute Myocardial Infarction

The focus of this review is to highlight the clinical importance of adding stress marker (copeptin) to conventional cardiac assays and their application in fast and accurate diagnosis of acute myocardial infarction in emergency settings. he leicesture Acute Myocardial infarction peptide study proved the usefulness of combination of copeptin level <14 pmol/l and troponin level <0.01ug/l. to rule out AMI, with negative predictive value (NPV) of 99.7% and higher sensitivity (98.8%). This finding from LAMP study concluded copeptin as a potential cardiac marker in 2007. Similarly, CHOPIN is the largest multi-center trial of this type to date with 1,967 patients with chest pain presenting to an emergency department within 6 hour after chest pain onset. In these patients AMI was the final diagnosis in 7.9%. This large, multicenter trial confirms that the combination of a negative troponin and negative copeptin on presentation allows the rule out of AMI for 58% patients with >99.2% negative predictive value. In addition copeptin value (>14 pmol/l) was able to detect greater numbers of patient with Acute myocardial infarction and Non ST elevation myocardial infarction at presentation when cardiac troponin was undetectable. Both elevated copeptin and troponin were predictors of death at 180 days and were independent of age and each other with additive negative predictive value. Sherpa N, Potential Clinical Application of Novel Cardiac Biomarker (Troponin) and Stress Marker (Copeptin) for the Diagnosis of Acute Myocardial Infarction in the Emergency Department
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Last date updated on June, 2014

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