1) The study measured levels of Copeptin, Urocortin, and high-sensitivity cardiac troponin T (hs-cTnT) in 75 emergency department patients with symptoms suggestive of cardiac disease. 2) Hs-cTnT levels were significantly higher in patients with cardiac disorders compared to other groups and may be useful for diagnosing acute myocardial infarction. 3) Copeptin and Urocortin levels did not differ significantly between patient groups and did not appear to provide additional diagnostic value beyond hs-cTnT measurement.

1. Copeptine, Urocortin and Troponin: measurement in emergency department patients S. Vandervinne, T. Lepoutre, F. Verschuren, D. Thys Cliniques Universitaires Saint-Luc, Brussels,Belgium 2011 Biochimie Biochemistry Poster 41

2. Introduction : 1) Copeptine, Urocortine : - two peptides related to stress and «fight or flight» response. - their use for the diagnosis and prognosis of cardiovascular disorders has recently been suggested. 2) Troponin : - remains the reference biomarker for the diagnosis of acute myocardial infarction (AMI) in emergency department (ED). - High-sensitive troponin-T (hsTnT) assays have recently been developed. The objective of our study : to determine the circulating concentrations of Copeptine, Urocortine and hs-cTnT levels in ED patients with symptoms suggestive of cardiac diseases.

3. Methods : 1) Seventy-five patients from ED were included in the study (AMI: 15 patients, cardiac arythmia: 9 patients, heart failure: 18 patients, infectious diseases: 9 patients, non-cardiopulmonary disorders: 24 patients). 2) Biomarkers levels were evaluated at admission : - Copeptine levels were determined with the Kryptor ® assay (Thermofisher). - Urocortin levels were measured with a specific ELISA (Uscn). - Concentrations of hs-cTnT were determined with the COBAS ® electrochemiluminescent assay (Roche). 3) Final diagnosis was established by ED physicians and Medical records.

4. hsTnT levels were significantly higher in patients with cardiac disorders (24.7 pg/mL,20.1, 25.6, 7.1 and 3.9 in AMI, CA, HF, ID and NCP,respectively) . Results : The Copeptin levels were not statistically different between the different groups (geometric means: 27.9 pmol/L, 23.9, 32.0, 14.5 and 13.3 in AMI, CA, HF, ID and NCP, respectively).

5. Results : Urocortin levels were also not statistically different between the different groups (20.3 pg/mL, 20.5, 15.4, 27.6 and 14.5 in AMI, CA, HF, ID and NCP, respectively).

6. Results : Biomarkers levels at admission in patients with AMI. Hs TPNT (ng/mL) Copeptine (pmol/L) Urocortine (pg/mL) 1691 27,95 543,87 331,6 10,94 12,5 93,33 185,8 12,5 91,32 68,05 12,5 78,44 4,8 12,5 76,49 197,5 12,5 36,78 219,4 33,5 30,79 10,4 12,5 7,76 150,2 12,5 7,59 17,42 12,5 4,96 7,32 28,93 3 13,31 12,5 3 55,25 27,23 3 7,45 12,5 3 5,4 29,72

7. Results : ROC curve analysis in our ED population with AMI as diagnostic criteria. Considering the ROC curve analysis a time course to follow hsTNT increase remains of interest . hsTPNT 0,663 (0,545 to 0,768) Copeptin 0,579 (0,459 to 0,692) Urocortin 0,558 (0,438 to 0,672) AUC

8. Conclusion : 1) Our study in the first to investigate simultaneously the levels of Copeptin, Urocortin and hsTnT in ED patients at admission. 2) In regards to our preliminary results, the value of Copeptin and Urocortin testing appears limited in comparison to measurement hsTnT for the exclusion diagnosis of cardiac disorders.