Prognostic value of elevated copeptin and high-sensitivity cardiac troponin T in patients with and without acute coronary syndrome: the ConTrACS study

Aims: We aimed to assess the prognostic role of copeptin in patients presenting to the emergency department with acute symptoms and increased high-sensitivity cardiac troponin T. Methods: A total of 3890 patients presenting with acute symptoms to the emergency department of Heidelberg University Hos...

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Main Authors: Waldsperger, Hanna (Author) , Biener, Moritz (Author) , Stoyanov, Kiril M. (Author) , Vafaie, Mehrshad (Author) , Katus, Hugo (Author) , Giannitsis, Evangelos (Author) , Müller-Hennessen, Matthias (Author)
Format: Article (Journal)
Language:English
Published: 11 November 2020
In: Journal of Clinical Medicine
Year: 2020, Volume: 9, Issue: 11
ISSN:2077-0383
DOI:10.3390/jcm9113627
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/jcm9113627
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2077-0383/9/11/3627
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Author Notes:Hanna Waldsperger, Moritz Biener, Kiril M. Stoyanov, Mehrshad Vafaie, Hugo A. Katus, Evangelos Giannitsis and Matthias Mueller-Hennessen

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520 |a Aims: We aimed to assess the prognostic role of copeptin in patients presenting to the emergency department with acute symptoms and increased high-sensitivity cardiac troponin T. Methods: A total of 3890 patients presenting with acute symptoms to the emergency department of Heidelberg University Hospital were assessed for increased hs-cTnT (>14 ng/L) from three cohorts: the Heidelberg Acute Coronary Syndrome (ACS) Registry (n = 2477), the BIOPS Registry (n = 320), and the ACS OMICS Registry (n = 1093). In a pooled analysis, 1956 patients remained, comprising of 1600 patients with ACS and 356 patients with non-ACS. Results: Median follow-up was 1468 days in the ACS cohort and 709 days in the non-ACS cohort. Elevated copeptin levels (>10 pmol/L) were found in 1174 patients (60.0%) in the entire cohort (58.1% in ACS and 68.5% in non-ACS, respectively) and mortality rates were significantly higher than in patients with normal copeptin levels (29.0% vs. 10.7%, p < 0.001). In a multivariate Cox regression, elevated copeptin was independently associated with all-cause death in the ACS (HR = 1.7, 1.3&ndash;2.3, p = 0.002) and non-ACS cohort (HR = 2.7, 1.4&ndash;5.0, p = 0.0018). Conclusion: Copeptin may aid in identifying patients at risk for adverse outcomes in patients with increased levels of hs-cTnT in ACS patients and in non-ACS conditions. 
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