DIAGNOSTIC VALUE OF SERUM AND PEPTIDE, BRAIN NATRIURETIC PEPTIDE AND CARDIAC TROPONIN IN ELDERLY PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Yongfu Chen, Xiaotao Han, Di Zheng, Qian Dong^*, Qiming Wu

Department of Cardiology, Beijing Ditan Hospital, Capital Medical University, Beijing, PR China

Objective: To explore the application of serum copeptin, brain natriuretic peptide (BNP) and cardiac troponin T (cTnT) in the early diagnosis of acute myocardial infarction in the elderly. 

Methods: A total of 100 elderly patients with acute myocardial infarction treated in our hospital from June 2018 to June 2019 were selected as the study group. Venous blood was collected 4 hours, 1 day, 4 days and 7 days after treatment. The levels of copeptin, BNP and cTnT in the serum of the patients were measured. The same age was randomly selected for physical examination in the same period at our hospital. Thirty healthy elderly people served as a control group. Copeptin, BNP and cTnT levels were detected and compared in each group. An ROC curve was drawn to evaluate the diagnostic value of copeptin, BNP and cTnT levels for elderly patients with acute myocardial infarction. Multivariate logistic regression was used to analyse the independent risk factors of acute myocardial infarction.

Results: The levels of copeptin, BNP and cTnT in the serum of the study group were significantly higher than those of the control group at each time point (P<0.05 or 0.01). The levels of copeptin and BNP in the serum of the study group began to rise after the onset of acute myocardial infarction, reached the highest level on day 1, then slowly decreased to the lowest level at day 7, with significant differences at each time point (P<0.05 or 0.01). The cTnT level of acute myocardial infarction in the study group increased rapidly to the highest level at 4h, then decreased slowly to the lowest level day 7, with a significant difference at each time point (P<0.05 or 0.01). The AUC of copeptin, BNP and cTnT in the diagnosis of acute myocardial infarction were 0.889, 0.863 and 0.841, respectively. When the critical value of copeptin was 14.81 Pmol/L, the sensitivity and specificity were 88.21 and 87.52%, respectively. When the critical value of BNP was 436.21ng/L, the sensitivity and specificity were 89.61 and 71.36%, respectively. When the critical value of cTnT was 20.36ng/L, the sensitivity and specificity were 76.32 and 80.23%, respectively. Multivariate logistic regression analysis showed that gender, copeptin, BNP and cTnT were independent predictors of acute myocardial infarction. Copeptin was positively correlated with BNP (r = 0.614, P<0.05), BNP was positively correlated with cTnT (r = 0.688, P<0.05), and copeptin was not significantly correlated with cTnT (P>0.05). Furthermore, gender was not significantly correlated with BNP, copeptin and cTnT (P>0.05).

Discussion: The levels of copeptin, BNP and cTnT in the serum of patients with acute myocardial infarction were significantly increased. Notably, the detection of copeptin, BNP and CTnT levels may play an important role in the early diagnosis of acute myocardial infarction in the elderly.