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Prognostic tools at hospital arrival in acute myocardial infarction: copeptin and hepatocyte growth factor
María-Consuelo Pintado1,2, Lara Maceda3, María Trascasa4
1Critical Care Unit, Hospital Universitario Príncipe de Asturias, Carretera Alcalá-Meco SN, 28805, Alcalá de Henares, Madrid, Spain. consuelopintado@yahoo.es.
Insights
Elevated copeptin levels upon hospital arrival predict higher mortality risk in acute myocardial infarction patients. Hepatocyte growth factor levels did not show a similar prognostic value in this study.
Area of Science:
- Cardiology
- Biomarker Research
- Clinical Prognostics
Background:
- Prompt management of acute coronary syndrome reduces mortality.
- Biomarkers are crucial for risk stratification in myocardial infarction.
- Copeptin and hepatocyte growth factor (HGF) have been linked to adverse outcomes in myocardial infarction.
Purpose of the Study:
- To assess the early prognostic value of copeptin and HGF.
- To determine their association with hospital and 1-year mortality in acute myocardial infarction patients.
Main Methods:
- Retrospective observational study design.
- Measurement of plasma copeptin and HGF at hospital admission.
- Follow-up of patients for 1-year mortality.
Main Results:
- Higher copeptin levels were significantly associated with both hospital mortality (p=0.01) and 1-year mortality (p=0.02).
- Hepatocyte growth factor levels showed no significant association with hospital mortality (p=0.73) or 1-year mortality (p=0.68).
- Included 84 patients (65% male, median age 70.3 years); hospital mortality was 11.9%, 1-year mortality was 21.4%.
Conclusions:
- Copeptin measurement at hospital arrival is a valuable tool for predicting prognosis in acute myocardial infarction.
- Elevated copeptin indicates increased risk of both short-term and long-term mortality.
- Hepatocyte growth factor did not demonstrate prognostic utility in this patient cohort.
Background:
Prompt evaluation and treatment of acute coronary syndrome has demonstrated to reduce mortality. Although several biomarkers have been studied for risk stratification and prognostic purposes, none is recommended to guide treatment based on its prognostic value. Copeptin and hepatocyte growth factor have been associated with poor outcome in patients with acute myocardial infarction. The aim of this study is to evaluate the early prognostic value of measurements of copeptin and hepatocyte growth factor for hospital mortality risk and 1-year-follow-up mortality, in patients with acute myocardial infarction. In our retrospective observational study, we measured hepatocyte growth factor and copeptin in blood samples collected at hospital arrival in patients with acute myocardial infarction; and follow-up them until 1-year.
Results:
84 patients with were included in the study, mainly male (65%) with a median age of 70.3 ± 13.56 years. Hospital mortality was 11.9%. Plasma levels of copeptin at hospital arrival were statistically significant higher in patients who died during hospital admission (145.60 pmol/L [52.21-588.50] vs. 24.79 pmol/L [10.90-84.82], p 0.01). However, we found no statistically significant association between plasma levels of hepatocyte growth factor and hospital mortality (381.05 pg/ml [189.95-736.65] vs. 355.24 pg/ml [175.55-521.76], p 0.73). 1-year follow-up mortality was 21.4%. Plasma levels of copeptin at hospital arrival were higher in those patients who died in the following year (112.28 pmol/L [25.10-418.27] vs. 23.82 pmol/L [10.96-77.30], p 0.02). In the case of HGF, we also find no association between hepatocyte growth factor plasma levels and 1 -year follow-up mortality (350.00 pg/ml [175.05-555.08] vs. 345.53 pg/ml [183.68-561.15], p 0.68).
Conclusions:
In patients with acute myocardial infarction measurement of copeptin at hospital arrival could be a useful tool to assess the prognosis of these patients, since their elevation is associated with a higher hospital mortality and higher 1-year follow-up mortality. We have not found this association in the case of hepatocyte growth factor measurement.
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