Abstract 15186: High Level of Copeptin in ST Elevation Acute Myocardial Infarction Patients is Associated with In-Hospital Mortality and Plaque Rupture; TAMI-COP Study
Background. Copeptin has been known to predict heart failure and cardiovascular death in patients with acute coronary syndrome.
Methods. We collected coronary arterial blood samples from the infarct artery during primary percutaneous coronary intervention (PCI) in 80 STEMI pts and 28 controls. We assessed commonly used cardiac biomarkers (CK, CK-MB, troponin-I, CRP) and additionally measured recently introduced biomarkers (Copeptin [C-terminal Provasopressin] and N-terminal pro-B-type natriuretic peptide [NT-proBNP]).
Results. Pt age was 58±12 yrs and 93% were males. Intravascular ultrasound (IVUS) of the culprit lesion in 67 pts showed ruptured plaques in 28 pts. STEMI pts had a higher Copeptin level (265.89±183.11 pmol/L) vs193.67±60.16 pmol/L in normal controls, p=0.005. Especially, Copeptin levels were higher in ruptured plaque compared to non-ruptured plaques: 318.83±209.34 pmol/L vs 221.99±151.49 pmol/L, p=0.034. While troponin I, CK-MB, and CRP were not correlated with Copeptin, NT-proBNP was correlated with copeptin (r=0.579, p=0.0003). In hospital death occurred in 7 pts with a high Copeptin level (figure); all were due to cardiogenic shock after primary PCI.
Conclusions. Copeptin levels are associated with plaque rupture in STEMI pts and predict mortality after primary PCI.
- © 2012 by American Heart Association, Inc.