The Changes And Their Clinical Significance Of Copeptin In Paitents With Acute Coronary Syndrome

Background:Acute coronary syndrome(ACS) is one of the common medicalemergency disease, the main pathogenesis is coronary unstable plaque rupture orerosion induced acute thrombosis induced acute myocardial ischemia syndrome, itincluding unstable angina pectoris(UAP), non-ST-segment elevation myocardialinfarction (NSTEMI),ST-segment elevation myocardial infarction (STEMI),et al.Theearly diagnosis,risk stratification and prognosis are so important to these patients withacute coronary syndrome.AS the precursor of arginine vasopressin(AVP),copeptin issecreted equal with arginine vasopressin(AVP) in the blood circulation.Copeptin in thebody is more stable and tested more convenient than arginine vasopressin.As one of thenew biomarkers of cardiovascular, copeptin has been more and more attentioned byresearchers.It may has a high clinical value that copeptin can be to earlydiagnosis,judgment risk stratification and prognosis to assess the ACS patients.Objective:To investigate the relationships of copeptin and acute coronary syndrome,andits clinical significance.Methods:A total of99patients had been treated in our department due to chest painfrom2013May to2013October were researched.According to the clinicalcharacteristics and medical history were divided into the control group(24cases),unstable angina pectoris(UAP group,27cases),non-ST-segment elevationmyocardial infarction(NSTEMI group,23cases) and ST-segment elevation myocardialinfarction(STEMI group,25cases);According to the results of coronary arteryangiography were divided into the control group(24cases),single-vessel diseasegroup(30cases),double-vessel disease group(26cases),three-vessel disease group(13cases)and left main coronary artery disease group(6cases).Collected the copeptin levelsof every patient in each group,and also the TC,TG,LDL,HDL,BMI and otherindicators,inquire about the hypertension,diabetes,smoking history,and calculation ofGensini scores,to analysis of the relationship between blood biochemical indexes,copeptin level and the severity of coronary artery lesion.Results:(1)The TC,TG,LDL,BMI,copeptin and Gensini scores of the patients in ACSgroup were significantly higher than those in the control group,the HDL lower than thecontrol group (P<0.01).(2)Copeptin level increased with disease severity (P<0.01).TheGensini scores increased with the severity of coronary heart disease, which hadstatistical difference between the UAP group and the NSTEMI group and also theSTEMI group (P<0.01);the NSTEMI group compared with the STEMI group has notStatistical difference(P>0.05).(3)The TC,TG,LDL,BMI,Gensini scores and copeptinincreases with the counts of coronary lesion vessels.The TC,TG,LDL,BMI,Gensiniscores and copeptin of the left main coronary artery disease group and the three-vesseldisease group were significantly higher than those of single-vessel group anddouble-vessel group(P<0.05);The Gensini scores and copeptin of left main coronaryartery disease group were significantly higher than the three-vessel diseasegroup(P<0.05).(4)After AMI,the copeptin level in patients with heart failure weresignificantly higher than those without heart failure (P<0.05).(5)There were positivecorrelation in ACS group between the Gensini scores,copeptin and TC,TG,LDL,BMIand negatively correlated with HDL.The Gensini scores was positively correlated tocopeptin(P<0.05).Conclousion:(1)There were positive correlation between plasma copeptin level and theseverity of coronary heart disease,and also the counts of coronary lesion vessels. It canbe used as one of the ACS risk stratification index.(2)The plasma copeptin level waspositively related with Gensini scores,and also closely related to the occurrence anddevelopment of ACS,can reflect the severity of coronary artery disease.(3)The copeptinin plasma of patients with AMI elevated significantly,some help for the early diagnosisof AMI;The plasma negative one have certain value to the exclusion of AMI,also hassome predictive value on the occurrence of heart failure after AMI.(4)The conventionalrisk factors of ACS such as TC,TG,LDL,HDL,BMI have some correlation withcopeptin,reflect copeptin may also interact with the lipid metabolic factor during thedevelopment of ACS.