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Association of copeptin with myocardial infarct size and myocardial function after ST segment elevation myocardial
Sebastian Johannes Reinstadler1, Gert Klug, Hans-Josef Feistritzer
1University Clinic of Internal Medicine III, Cardiology, Innsbruck Medical University, Innsbruck, Austria.
Insights
Elevated copeptin levels two days after ST-elevation myocardial infarction (STEMI) correlate with larger infarct size and impaired heart function. This biomarker may predict adverse outcomes and cardiac remodeling post-STEMI.
Area of Science:
- Cardiology
- Biomarker Research
- Medical Imaging
Background:
- ST-segment elevation myocardial infarction (STEMI) is a critical condition requiring prompt reperfusion.
- Assessing infarct size and myocardial function post-STEMI is crucial for predicting patient outcomes.
- Copeptin, a marker of the arginine vasopressin system, has emerged as a potential biomarker in cardiovascular diseases.
Purpose of the Study:
- To investigate the relationship between plasma copeptin levels and infarct size.
- To assess the association of copeptin with myocardial function and remodeling at baseline and 4 months post-STEMI.
- To determine copeptin's predictive value for adverse outcomes after mechanical reperfusion in STEMI patients.
Main Methods:
- Prospective observational cohort study of 54 acute STEMI patients.
- Contrast-enhanced cardiac MRI was used to measure infarct size and left ventricular ejection fraction (LVEF) at baseline and 4 months.
- Plasma copeptin levels were measured by immunofluorescent assay 2 days after symptom onset.
Main Results:
- Copeptin concentrations positively correlated with early and chronic infarct size (r=0.388, p=0.004; r=0.385, p=0.011).
- Copeptin levels were inversely related to LVEF at baseline and 4 months (r=-0.484, p<0.001; r=-0.461, p<0.001).
- Higher baseline copeptin was observed in patients with adverse remodeling, with a cut-off of 16.7 pmol/l predicting future adverse remodeling.
Conclusions:
- Increased copeptin values 2 days post-STEMI are associated with larger acute and chronic infarct sizes.
- Elevated baseline copeptin correlates with impaired myocardial function and adverse remodeling 4 months after STEMI.
- These findings support copeptin's role as a valuable biomarker for predicting adverse outcomes in STEMI.
Objective:
To investigate the relationship between circulating plasma copeptin values and infarct size as well as myocardial function at baseline and 4 months after mechanical reperfusion for ST segment elevation myocardial infarction (STEMI).
Design:
Prospective observational cohort study.
Setting:
University Hospital of Innsbruck.
Patients:
54 patients with acute STEMI.
Main Outcome Measures:
Correlation of plasma copeptin with infarct size as well as left ventricular ejection fraction (LVEF) and remodelling.
Methods:
Participants underwent contrast enhanced cardiac MRI at baseline and 4 months thereafter. Blood samples were drawn 2 days after the onset of symptoms. Copeptin values were determined by an immunofluorescent assay.
Results:
Copeptin concentrations (median 10.4 pmol/l, IQR 6.0-14.4) were associated with early and chronic infarct size (r=0.388, p=0.004 at baseline; r=0.385, p=0.011 at follow-up) and inversely related to LVEF at both times (r=-0.484, p<0.001 at baseline; r=-0.461, p<0.001 at follow-up). Patients with adverse remodelling showed higher baseline copeptin values compared to patients without remodelling (p=0.02). Receiver operating characteristic analysis indicated a cut-off value of 16.7 pmol/l for copeptin to best identify patients with future adverse remodelling.
Conclusions:
Increased copeptin values 2 days after STEMI are associated with larger acute and chronic infarct sizes. Moreover, elevated copeptin concentrations at baseline were associated with myocardial function and remodelling 4 months post-STEMI. These findings strengthen the role of copeptin as a biomarker of adverse outcome after STEMI.
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