Copeptin, Troponin-I, Pro-BNP and hs-CRP levels in Diagnosing Acute Coronary SyndromesMehmet Tugrul Inanc*, Nebi Cerit, Deniz Elcik, Nihat Kalay, Mehmet Gungor Kaya, IbrahÄ±m Ozdogru, Ali Dogan, Abdurrahman Oguzhan and Aysun Cetin
Faculty of Medicine, Cardiology Department, Erciyes University, Kayseri, Turkey
- Corresponding Author:
- Mehmet Tugrul Inanc
Faculty of Medicine, Cardiology Department
Erciyes University, Kayseri, Turkey
Tel: +90 352 207 6666-27789, +90 505 388 3440
Fax: +90 352 437 6327
E-mail: [email protected]
Received date: February 07, 2016 Accepted date: March 04, 2016 Published date: March 07, 2016
Citation:Inanc MT, Cerit N, Elcik D, Kalay N, Kaya MG, et al. (2016) Copeptin, Troponin-I, Pro-BNP and hs-CRP levels in Diagnosing Acute Coronary Syndromes. Angiol 4:169. doi:10.4172/2329-9495.1000169
Copyright: © 2016 Inanc MT, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Chest pain is a frequent symptom patients present with to the emergency room. Copeptin, the Cterminal fragment of arginine-vasopressin, is a marker of stressful situations. Recent studies showed that normal levels of copeptin combined with a normal troponin accurately excluded the diagnosis of acute coronary syndrome (ACS). In this prospective, single center study we evaluated if negative levels of copeptin, pro-BNP and hs-CRP combined with negative troponin (cTn-I) can accurately rule out the diagnosis of ACS and also other life-threatening causes of chest pain.
Results: Of 120 enrolled patients (69.2% males, median age 60 yrs), 31.7% were diagnosed with ST elevation myocardial infarction (STEMI), 17.5% with non STâÂ€Âelevation myocardial infarction (NSTEMI), 17.5% with unstable angina (USAP), 12.5% stable angina pectoris (SAP) and 20.8% normal coronary arteries (NCA). Copeptin levels were significantly higher in ACS patients with STEMI and NSTEMI than in those with other diagnoses (0.855 ± 0.279 vs. 0.516 ± 0.127, p<0.001). In the correlation analyses, copeptin and cTn-I, and copeptin and pro-BNP were positively correlated (r values 0.397; p<0.001). Diagnostic accuracy of copeptin over 0.583, had 91% sensitivity and 79% specificity the myocardial infarction (95% CI 0.86 to 0.91).
Conclusions: The combined use of copeptin, pro-BNP, hs-CRP and cTn-I significantly improved the diagnostic accuracy of troponin alone both in myocardial infarctions and in other life-threatening diseases. Measurement of these markers might be therefore considered not only as a rule-out strategy but also as a warning sign of lifethreatening disease.