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Abstract
Background: Acute coronary syndrome is a worldwide extremely important disease , during the last few decades a lot of biomarkers especially cardiac troponins play a critical role in diagnosis, management and prognostic prediction of acute coronary syndrome, novel biomarkers continue to be studied , copeptin is one of these emerging biomarkers which is a peptide released as a response to endogenous vascular stress, when combined with troponin it could help in early ruling out of acute coronary syndrome and shorten the emergency department and chest pain unit{u2019}s stay. Objectives: To evaluate the value of copeptin in combination with conventional troponin-I to rule out an acute coronary syndrome early in the emergency department. Patients and methods: A total of 52 patients were recruited in this prospective longitudinal analytic study which was conducted in Cairo University Hospitals, In the period between February 2016 and August 2016, mean age was (55± 9), males were 38 (73.3%) and 14(26.7%) were females presented to the emergency department complaining of typical anginal chest pain. All patients were subjected to thorough history taking, including sex, history of smoking, diabetes, hypertension,family history of coronary artery disease, history of coronary angiography, history of peripheral vascular disease, myocardial infarction, congestive heart failure and chronic obstructive pulmonary disease. Analysis of lipid profile, measurement of serum creatinine and fasting plasma glucose, serum level of troponin, creatine kinase (CK) and creatine kinase myocardial band (CKMB) and the serum copeptin with the commercial ELISA test. Electrocardiogram was done on admission and then coronary angiography and primary PCI was done or coronary angiography was done within 72 according to indications for 48 patients and exercise testing electrocardiogram was done for the rest of the patient