Single-Sample, Dual-Biomarker Testing for Patients with Chest Pain in the ED

Measuring both copeptin and cardiac troponin on presentation reliably ruled out acute coronary syndromes in a small study.

Emergency departments (EDs) must quickly and reliably rule out acute coronary syndromes (ACSs). Despite recent research into a 1-hour rule-out using high-sensitivity troponin levels (NEJM JW Cardiol Mar 2016 and Ann Emerg Med 2016 Jan 12; [e-pub]), this approach is insufficient without assessment of cardiac risk. Researchers compared the value of measuring both ultrasensitive copeptin (which peaks rapidly after acute stress) and medium-sensitivity cardiac troponin I (cTnI), using a single sample, with that of measuring cTnI at 0 and 3 hours. They enrolled 196 consecutive patients who presented to an ED in Italy within 6 hours after chest-pain onset; none had ST-segment elevation on 12-lead electrocardiography. Copeptin assays were manufactu…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Single-Sample, Dual-Biomarker Testing for Patients with Chest Pain in the ED

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Reviewing Author