Influence of copeptin in determining the risks of short-term mortality and development of repeated acute coronary events for patients without ST-segment elevation

Abstract

Summary. The purpose of this study was to assess the influence of the Copeptin level on short-term prognosis for patients with acute coronary syndrome without ST-segment elevation combined with the definition of the levels of Troponin T.
Materials and methods. Prospective single center study included 128 patients with suspected acute coronary syndrome (ACS) without ST-segment elevation with risk factors for CHD, selected according to criteria of inclusion/exclusion, received information on the study and gave their written consent to participate. Within the framework of the study, levels of Troponin T and Copeptin were determined for every patient at the admission, a diagnostic test of Troponin T was repeated in 12–72 hours. Observation period during the whole phase of hospitalization of research participants averaged 7.5 ± 3.5 days. The achievement of endpoints during monitoring was assessed (development of repeated acute cardiovascular complications, death, congestive heart failure, emergency repeated coronary intervention). The role of Copeptin in the diagnosis
of myocardial necrosis and its correlation with the level of development of cardiovascular complications and
hospital mortality was determined.
Results. In the surveyed sample of patients with ACS without ST-segment elevation of admissions Copeptin > 2.95 ng/ml was associated with an increased risk of death and a credible development of repeated acute cardiovascular events – RR 96.86 [13.60; 689.68 p < 0.00001] with positive prognostic value of 100.00% (95% CI 75.75%-100.00%) the observation period averaged 7.5 ± 3.5 days.
Conclusions. Copeptin may be used as a new prognostic marker of the risk of repeated acute cardiovascular complications and death of patients with ACS without ST-segment elevation, irrespective of traditional risk factors. The combined strategy of defining Copeptin and Troponin T is more informative in predicting risks and outcomes than tactics of research of each marker taken separately and can be useful for stratifying risk and prediction of hospital mortality of patients with ACS without ST-segment elevation.