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Background: Copeptin in combination with troponin is useful in the early rule-out of chest pain patients with suspected non-ST-elevation myocardial infarction. To date, no evidence is available on baseline characteristics and copeptin values of chest pain patients with syncope in the emergency department (ED).
Methods: We measured copeptin and high-sensitivity cardiac troponin I (hs-cTn I) in 700 consecutive ED patients presenting with chest pain. Retrospectively, we selected those with a concomitant syncopal episode. Copeptin values above 10 pmol/L were considered positive.
Results: Sixteen patients (males=8) were found; with mean age 72.3±18.4 years. All patients exhibited elevated copeptin levels (median 54.3 pmol/L, IQR 31.7 to 147.0 pmol/L) with no statistical difference (p-value =0.40) by sex. Five of 16 patients with recent syncope had elevated hs-cTnI at 0/3 h and presented with deep venous thrombosis/pulmonary embolism in two cases and acute coronary syndromes in three. Syncope in 7 of the 11 patients with normal troponin values was most likely due to worsening of their cardiovascular comorbidities. The remaining patients likely experienced a vasovagal syncope as no major comorbidities were found.
Conclusions: Elevated copeptin in combination with normal troponin levels are mainly seen in patients experiencing non-coronary chest pain and syncope. Larger studies are warranted to reveal associations and potential confounders.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias and Clinical EP: Syncope and Other EP Issues
Abstract Category: 6. Arrhythmias and Clinical EP: Other
Presentation Number: 1279-089
- 2017 American College of Cardiology Foundation