Abstract
Suspected acute myocardial infarction is one of the leading causes of admission to emergency departments. In the last decade, biomarkers revolutionized the management of patients with suspected acute coronary syndromes. Besides their pivotal assistance in timely diagnosis, biomarkers provide additional information for risk stratification. Cardiac troponins I and T are the most sensitive and specific markers of acute myocardial injury. Nonetheless, in order to overcome the remaining limitations of these markers, novel candidate biomarkers sensitive to early stage of disease are being extensively investigated. Among them, copeptin, a stable peptide derived from the precursor of vasopressin, emerged as a promising biomarker for the evaluation of suspected acute myocardial infarction. In this review, we summarize the currently available evidence for the usefulness of copeptin in the diagnosis and risk stratification of patients with suspected acute myocardial infarction in comparison with routine biomarkers.
Highlights
The discovery of the biomarker cardiac troponin as well as its introduction as a test into clinical routine has been one of the most important advances in the evaluation of patients with suspected acute myocardial infarction (AMI) over the last decades
We summarize the currently available evidence for the usefulness of copeptin in the diagnosis and risk stratification of patients with suspected acute myocardial infarction in comparison with routine biomarkers
Whether copeptin is of prognostic value among patients with AMI was studied for the first time by Khan et al in the Leicester Acute Myocardial Infarction Peptide (LAMP) study [38]
Summary
The discovery of the biomarker cardiac troponin (cTn) as well as its introduction as a test into clinical routine has been one of the most important advances in the evaluation of patients with suspected acute myocardial infarction (AMI) over the last decades. A further clinically relevant increase in the sensitivity of cTn at an early diagnostic stage was achieved with the introduction of high-sensitivity (hs) cTn assays [2–4]. Despite these advances, there remains a troponin-blind period very early after symptom onset. The role of novel biomarkers other than that of the routinely used cTn, NPs, and hs-CRP that might enable a better risk stratification of patients with chest pain is being increasingly investigated [20–25]. We will summarize the current clinical evidence for its routine use in patients with suspected AMI
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