The use of the biomarker “copeptin” for the diagnosis of acute chest pain in the Emergency Department

The aim of the study is to assess if copeptin, in combination with negative troponin, is able to accelerate the rule-out of AMI in patients with chest pain. The study was retrospectively conducted on three groups of patients selected according to their discharge diagnoses: patients with non-ST elevation myocardial infarction (NSTEMI), non-cardiac chest pain (NCCP), unstable angina (UA). Comparing the levels of copeptin, we found that the diagnosis of AMI is associated more often with copeptin positive values (> 14 pmol/l) than the diagnosis of NCCP and UA. However, about a quarter of our patients in which the combination of copeptin and troponin in the first blood sample was negative, the final diagnosis was AMI. According to our results, the combination of the two negative markers does not allow a safe rule out of AMI at time zero.