Clinical InvestigationAcute Ischemic Heart DiseaseComparison of the performances of cardiac troponins, including sensitive assays, and copeptin in the diagnostic of acute myocardial infarction and long-term prognosis between women and men
Section snippets
Study design and population
The Advantageous Predictors of Acute Coronary Syndrome Evaluation is an ongoing prospective international multicenter study designed and coordinated by the University Hospital Basel, Switzerland.13 Briefly, consecutive patients presenting to the ED with symptoms suggestive of AMI of <12 hours have been included, after informed consent, and were followed up at regular intervals. Patients with terminal kidney failure requiring dialysis were excluded. The objective of the present study was to
Study population
A total of 1,247 patients were included in the present analysis, comprising 420 women (34%) and 827 men (66%). Baseline characteristics according to gender are listed in Table I. The adjudicated final diagnosis was AMI in 198 patients (15.9%) (14.5% in women vs 16.6% in men, P = .351), including NSTEMI in 148 patients (11.9%) (10.7% in women vs 12.4% in men, P = .369). Other diagnosis included unstable angina in 174 patients (14.0%) (8.8% in women vs 16.6% in men, P = .002), cardiac but
Discussion
We report 4 major findings. First, we found important gender differences regarding the final diagnoses underlying acute chest pain. Although women had similar rates of AMI, including NSTEMI, they more frequently had cardiac but noncoronary causes of chest pain and less frequently had unstable angina than men. Second, there was no significant difference in the diagnostic accuracy of cTnT, hs-cTnT, and copeptin, alone or in combination, in women versus men; hs-cTnT and the combination of cTn and
Acknowledgements
We thank the patients who participated in the study; the staff of the EDs; the laboratory technicians; and, particularly, Claudia Stelzig, Michael Freese, Kirsten Hochholzer, Esther Garrido, Irina Klimmeck, Melanie Wieland, and Fausta Chiaverio for their most valuable efforts, and we thank Drs C. Schindler and K. Denhaerynck for expert statistical advice.
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2020 ESC Clinical Practice Guidelines for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndrome
2021, Revista Espanola de CardiologiaExercise-induced cardiac troponin elevation: An update on the evidence, mechanism and implications
2019, IJC Heart and VasculatureCopeptin as a prognostic biomarker in acute myocardial infarction
2019, International Journal of CardiologyCitation Excerpt :As such, copeptin could be considered a marker of both myocardial injury and hemodynamical stress. On the basis of the distribution of copeptin, different potential cutoff values were considered [10,30–32] and a recent systematic review [11] suggested that the use of different cut-points did not significantly impact diagnostic accuracy. In our study, the median copeptin was 36.2 pmol/L, which is higher than previous studies performed in the same clinical setting [5,15,22,33] which could be explained by the early measurement in our study as compared with the others.
Fourth Universal Definition of Myocardial Infarction (2018)
2018, Global HeartCitation Excerpt :For some hs-cTn assays, sex-specific cut-off values have been reported to improve diagnostic and prognostic information in patients with possible acute MI [128,129]. However, there is controversy as to whether this approach provides valuable additional information for all hs-cTn assays [130]. Blood samples for the measurement of cTn should be drawn on first assessment (designated as 0 h) and repeated 3 – 6 h later, or earlier with hs- cTn assays.
Fourth Universal Definition of Myocardial Infarction (2018)
2018, Journal of the American College of CardiologyClinical role of serum Copeptin in acute coronary syndrome
2018, Egyptian Heart Journal
Clinical Trial Registration: http://clinicaltrials.gov/ct2/show/NCT00470587.
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Both authors have contributed equally and should be considered first author.