The incremental value of combination copeptin and troponin T for early diagnosis of acute myocardial infarction

  • Daniel R Mulyono Fourth grade students of Faculty of Medicine University of Indonesia
  • Arfenda P Mustikawati Fourth grade students of Faculty of Medicine University of Indonesia
  • Galuh A Tyagitha Fourth grade students of Faculty of Medicine University of Indonesia
  • Anthony Wijaya Fourth grade students of Faculty of Medicine University of Indonesia
  • Irna C Wyrahardja Fourth grade students of Faculty of Medicine University of Indonesia
  • Yoga Yuniadi Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia
DOI: https://doi.org/10.30701/ijc.v32i2.108

Abstract

Background: Copeptin is a protein that is released when the body experiences endogenic stress. The level of copeptin elevated very early and slowly decreases in myocardial infarction.
Aim: to determine the incremental value of combination copeptin and troponin T for early diagnosis of Acute Myocardial Infarction.
Methods: A search was conducted on PubMed and Cochrane. After screening title and abstract using inclusion and exclusion criteria, three articles were available as full text, but only 2 articles were considered useful by authors and were appraised based on its validity, importance and applicability. The other one article was excluded because the outcome of the study basically differentiates ACS and cardiomyopathy.
Results: Both articles showthat the diagnostic value results are not so different. From the first article, a combination of copeptin and troponin T gives the results of sensitivity 87.4%, specificity 66.2%, PPV 46.9%, NPV 93.9%, pre-test probability 21.5%, post-test probability 40.8%, and AUC 0.91. The second article showed a combination of both gave sensitivity values of 98.8%, specificity 77.1%, PPV 46.2%, NPV 99.7%, pre-test probability 16.67%, and post-test probability 46.29%, and AUC 0,97.
Conclusion: the combination of troponin T increase the sensitivity of diagnosis of AMI among patients suspected with acute coronary syndrome compared to troponin T alone. The combination of both can be considered as a test to diagnose AMI at early hours.

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References

Coven DL.Acute coronary syndrome Available at: http://emedicine.medscape.com/article/1910735-overview. Accessed on June 3rd 2011

Babuin L, Jaffe AS.Troponin: the biomarker of choice for the detection of cardiac injury.CMAJ November 8, 2005; 173 (10). doi:10.1503/cmaj/051291

Morgenthaler NG. Copeptin: a biomarker of cardiovascular and renal function.Congest Heart Fail. 2010;16(4)(suppl 1):S37–S44.

Keller T, et al. Copeptin improves early diagnosis of acute myo-cardial infarction. J Am CollCardiol. 2010; 55:2096-2106.

Reichlin T, et al. Incremental value of copeptin for rapid rule out of acute myocardial infarction. J Am CollCardiol. 2009 Jun 30;54(1):60-8
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How to Cite
Mulyono, D., Mustikawati, A., Tyagitha, G., Wijaya, A., Wyrahardja, I., & Yuniadi, Y. (1). The incremental value of combination copeptin and troponin T for early diagnosis of acute myocardial infarction. Indonesian Journal of Cardiology, 32(2), 113-7. https://doi.org/10.30701/ijc.v32i2.108
Issue
Vol. 32, No. 2 April - Juni 2011
Section
Case Reports

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